Curative effect of three-dimensional porous core decompression combined with autologous bone marrow transplantation on phase Ⅰ, Ⅱ avascular necrosis of the femoral head / 中国组织工程研究

ABSTRACT

BACKGROUND: Hip-preserving treatment is advocated in the treatment of early avascular necrosis of the femoral head.OBJECTIVE: To compare the clinical efficacy of simple core decompression and three-dimensional porous core decompression combined with autologous bone marrow transplantation on early avascular necrosis of the femoral head.METHODS: Thirty patients (39 hips) with early avascular necrosis of the femoral head at phase I-II according to the staging criteria of the Association Research Circulation Osseuse (ARCO) who had been admitted to the First Affiliated Hospital of Luzhou Medical University between March 2011 and May 2016 were surgically treated and followed up.Seventeen patients (22 hips, trial group) were treated with three-dimensional porous core decompression combined with autologous bone marrow transplantation, including 10 cases of ARCO stage I and 12 cases of ARCO stage II; the other 13 patients (17 hips, control group) were treated with simple core decompression, including 7 cases of ARCO stage I and 10 cases of ARCO stage II. Harris scores, X-ray and magnetic resonance imaging were used to evaluate the surgical efficacy at 1, 3, 6, 9, 12, 18, 24, 30, 36 months after the operation.RESULTS AND CONCLUSION: The incision healed primarily in all patients, and no infection occurred. The follow-up lasted for 1-3 years (average 2.5 years). At the last follow-up, the Harris scores in both trial group and control group were significantly improved compared with the baseline (P < 0.05); moreover, the Harris scores of ARCO stage I and II patients were significantly higher in the trial group than the control group (P < 0.05). Collapse of the femoral head was observed in one hip (stage I) and one hip (stage II) of the trial group, and in three hips (stage I) and five hips (stage II) of the control group, and then hip arthroplasty was performed. The number of the patients developing collapse of the femoral head in the trial group was significantly less than that in the control group (P < 0.05). Compared with simple core decompression, three-dimensional porous core decompression combined with autologous bone marrow transplantation is more adept to improve patient's function and delay disease progression in the treatment of ARCO stage I and II early avascular necrosis of the femoral head.