ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical efficacy of the pith decompression of the femoral head and fibular allograft transplantation in the treatment of early stage avascular necrosis.</p><p><b>METHODS</b>From January 2004 to November 2008, 32 hips of 25 patients with avascular necrosis of femoral head of Ia-IIIb period were treated by the pith decompression of the femoral head and fibular allograft transplantation, hollow lag screw fixation, included 17 males and 8 females, aged from 20 to 55 years old (39.1 years on average). Preoperative pain was from 2 to 14 months (means 5.5 months). All patients were applied on conventional X-ray films, MRI examination, Harris score.</p><p><b>RESULTS</b>The patients were followed up for 12 to 48 months (means 36.4 months). X-ray film showed 21 hips of 18 cases improved,6 hips of 4 cases unchanged, no collapse of articular surface, 3 hips of 2 cases deterioration, 2 hips of 1 case failed. Preoperative Harris score was (77.0 +/- 8.0) and postoperative (90.6 +/- 2.5), there was a significant difference (t = 1.67, P < 0.05).</p><p><b>CONCLUSION</b>Pith decompression of the femoral head and fibular allograft transplantation in the treatment of early stage avascular necrosis of femoral head has advantage of joint function in bed-ridden after a short time, quick recovery,clinical symptoms improved. Its short-term efficacy is certain but long-term efficacy is still need further observation.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Decompression, Surgical , Methods , Femur Head Necrosis , General Surgery , Fibula , Transplantation , Transplantation, HomologousABSTRACT
<p><b>OBJECTIVE</b>To evaluate clinical effect of micro-modified Fulkerson osteotomy under arthroscope in treating habituation patellar dislocation.</p><p><b>METHODS</b>Twenty patients of habituation patellar dislocation (25 knees) were treated by the medial retinaculum plication, lateral retinaculum releasing and modified Fulkerson osteotomy (tibial tubercle anteromedial transfer) under arthroscope. There were 5 males and 15 females with the age from 16- to 28-years-old (average of 21 years). The subjective symptoms and the joint function were evaluated according to Lysholm and Tegner scoring system.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 36 months with an average of 24 months. No found redislocation in the patients. The Lysholm score was 54.4 +/- 12.1 and 87.7 +/- 9.6 (t=2.33, P<0.05) before and after surgery respectively. The Tegner score was 2.8 +/- 0.8 and 5.1 +/- 1.3 (t=4.36, P<0.01) before and after surgery respectively.</p><p><b>CONCLUSION</b>Micro-modified Fulkerson osteotomy under arthroscope for the treatment of habituation patellar dislocation is a rescheduled in extend knee equipment, its advantages including affirmative effect, minor damage, quick rehabilitation, fewer complications and lower rate of recurrence after operation.</p>