ABSTRACT
Objective To evaluate the clinical outcome associated with the core decompression in combination with the nano-hydroxyapatite/collagen composite rod combined with decalcified bone matrix in a consecutive series of patients with osteonecrosis of femoral head,especially the prevention of collapse of femoral head and its predisposing factors.Methods From August,2012 to May,2013,46 pationts (50 hips) who had undergone core decompression in combination with nano-hydroxyapatite/collagen composite rod insertion in corporated with decalcified bone matrix in our hospital were involved in this study.Postoperative care consisted of prophylactic intravenous antibiotic and anticoagulation therapy.Patients were instructed to be non-weight-bearing for 3 weeks,to partial weight-bear for the next 3 weeks,and to weight bear as tolerated thereafter.All patients were evaluated both clinically and radiographically.The primary clinical outcome of this study was functional improvement assessed with the Harris hip score.Serial radiograms of the pelvis were taken at 1,3,6,12 months post-operatively to analyze the process of osteonecrosis.Results All patients followed up for 12 months,no one suffer complications.The mean Harris score pre-operation was 65.6 ± 10.6,post-operation score was 87.5 ± 15.3,with a mean improvement of 21.8 ± 13.2 (P ＜ 0.05).According to Harris hip score system,excellent for 30 hips,good for 14 hips,fair for 2 hip and poor for 4 hips.Refer to the Kaplan-Meier survivorship curve,the success rate at 12 months post-operatively was 92％.Radiological changes coincided with clinical changes.Conclusion Core decompressionin combination with nano-hydroxyapatite/ collagen composite rod insertion in corporated with decalcified bone matrix provided a minimally invasive surgical treatment option to treat early stage osteonecrotic hips(stage Ⅰ and Ⅱ) and to prevent femoral heads from collapsing,with clinical outcomes and success rates priorto other commonly used surgical procedures.
ABSTRACT
Objective:To study the bone-conductivity and absorbability of nano-hydroxyapatite/collagen(nHAC) composite implanted under the calvarial periosteum in rabbits.Methods:24 nHAC samples and 24 HA samples were prepaired in the shape of round disk with the diameter of 8 mm and thickness of 3 mm.nHAC samples were implanted under calvarial periosteum on the left side and HA samples on the right of 24 rabbits.The bone-conductivity and absorbability of the samples were examined by new bone height measuring and residual implant materia measuring 2,4,8 and 12 weeks after operation. Results:2,4,8 and 12 weeks after implantation new bone height(mm) in nHAC group was 0.54?0.09,0.72?0.12,1.83?0.14 and 2.63?0.07,that in HA group 0.13?0.11,0.31?0.12,1.23?0.05 and 1.75?0.14,respectively(P