Platelet-rich plasma combined with surgical hip joint dislocation:An effective option for femoral head necrosis in the peri-collapse stage / 医学研究生学报

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.