ABSTRACT
Objective Reports are rarely seen about the application of platelet-rich plasma (PRP) combined with surgical dislocation of head and neck fenestration (HNF) in the treatment of osteonecrosis of the femoral head (ONFH) in the peri-collapse stage. The purpose of this study was to investigate the clinical effects of PRP combined with surgical dislocation of HNF in the treatment of ONFH. Methods Using PRP combined with surgical dislocation of HNF,we treated 18 ONFH patients with 22 hips involved,in-cluding 7 cases of ARCO stage Ⅱc,10 cases of stage Ⅲa,and 5 cases of stage Ⅲb, and followed them up for 12.40±3.12 months. We evaluated the clinical results and compared the Harris scores and radiographic manifestations obtained before and after surgery. Results The overall Harris scores of the patients at 12 months after surgery were significantly higher than the baseline(86.84±6.44 vs 73.73±5.42,P=0.04),(87.73±2.43 vs 74.23±7.30,P<0.05) in the stageⅡc group,(85.22±7.63 vs 72.82±5.31,P<0.05) in the stageⅢa group,and(78.86±5.91 vs 69.37±6.13,P<0.05) in the stageⅢb group. The rate of excellence was 90.91% and that of im-provement was 95.45%.There were no such postoperative complications as nonunion,infection,or osteothrombosis. Conclusion PRP com-bined with surgical dislocation of HNF exhibited an excellent short-term effect in the treatment of ONFH in the peri-collapse stage, which has provided a new option for the management of the disease.
ABSTRACT
The pathogenesis of steroid-induced osteonecrosis of the femoral head (SONFH) is not very clear at present. For the past few years researches showed that the SONFH related to genetic predisposing factors. The related research progresses were reviewed in this article to show the correlation between genetic mutation and genetic polymorphism of steroid metabolism and transport, resistance and receptor, coagulation and fibrinolysis, lipid and bone metabolism and susceptibility to SONFH. The article also discussed current problems, countermeasure and future applications.