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BACKGROUND: To delay the further aggravation of early femoral head necrosis, drilling decompression of the femoral head is a better treatment method. However, traditional trepanation and decompression of the femoral head is traumatic. OBJECTIVE: To compare the difference in the effect between robot-assisted drilling decompression and traditional surgery for aseptic necrosis of femoral head. METHODS: Forty patients with aseptic necrosis of the femoral head were included for retrospective comparative analysis. According to the treatment plan, they were divided into two groups. Eighteen cases (26 femoral heads) in the robot group were treated with drilling decompression assisted by robots. Among them, 13 cases (18 femoral heads) were in Ficat stage I and 5 cases (8 femoral heads) were in Ficat stage II. The traditional surgery group consisted of 22 patients (29 femoral heads). Among them, 15 patients (19 femoral heads) were in Ficat stage I and 7 patients (10 femoral heads) in Ficat stage II. Incision, times of intraoperative fluoroscopy, intraoperative blood loss, times of intraoperative puncture and operation time were compared between the two groups. Harris score was used before and 1, 3, and 6 months after operation to evaluate the hip effect. RESULTS AND CONCLUSION: (1) All cases were followed up for 6 months. (2) Incision, times of intraoperative fluoroscopy, intraoperative blood loss, times of intraoperative puncture and operation time were better in the robot group than in the traditional surgery group (P 0.05). (4) Compared with the traditional surgery, robot-assisted drilling decompression has no obvious advantage in the treatment of aseptic necrosis of the femoral head. However, its operation incision is small; the number of intraoperative fluoroscopy is small; the trauma is small; and the operation is safer and minimally invasive.
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Objective To investigate the effect and mechanism of transplantation of marrow multi- function stem ceils in treating femoral head necrosis.Methods Sixty japanese rabbits were divided into A,B and C groups randomly.After creation of the models of hormone induced necrosis of femoral head;A group was designated as the treatment,B as the control and C as the normal groups.The bone marrow of A group was extracted and isolated and then injected into the left femoral head and the right femoral head was decompressed by drilling only.The rabbits were killed at 8 weeks after the treatment and changes in various parameters were observed,including imaging data of molybdenum target films,CT and MRI;routine pathology with HE staining and ultrastructural alteration by election microscopy.Results Eight weeks after the treatment of transplantation of marrow multifunction stem cells,the X-ray showed only a little change but the typical appearances were revealed by CT and MRI.Pathohistologic manifestation demonstrated decrease of empty bone lacuna,increase of osteoblast and new bone formation.Election microscopy displayed abundant organelles in osteoblasts with few empty bone lacuna,in addition the tansplantation of marrow multifunction stem cells could obtain better reconstraction for the involved femoral head.Conclusions The treatment of transplantation of marrow muhifunction stem cells in femoral head necrosis could accelerate the process of repairing,worthy to be acknowledged as a good and valuable management in rabbits.(J Intervent Radial,2007,16:122-126)