Vascularized greater trochanter or iliac periosteal flap displacement repairs avascular necrosis of femoral head / 中国组织工程研究

ABSTRACT

BACKGROUND:Femoral head avascular necrosis is common in children and elderly. Though, there are many methods can be used for the treatment, it has been inconclusive in the treatment according to the age and stage of the patients. OBJECTIVE:To treat the femoral head avascular necrosis with different methods according to the age and stage, and to retrospectively analyze the fol ow-up results. METHODS:Total y 202 patients (242 hips) with femoral head avascular necrosis were included from October 1998 to October 2008. The patients were divided into groups according to age, included child group (4-14 years old, n=45, 47 hips);youth group (15-45 years old, n=100, 125 hips);and elderly group (46-81 years old, n=57, 70 hips). The patients in the child group were treated with vascularized greater trochanter or iliac periosteal flap displacement, the patients in the youth group were treated with vascularized greater trochanter or iliac periosteal flap displacement, and the patients in the elderly group were treated with hybrid or cementless total hip arthroplasty. RESULTS AND CONCLUSION:Al the 202 patients were fol owed-up for 6 months to 10 years, average 6.3 years. The excellent and good rate of the child group, youth group and elderly group were 87%, 89%and 86%respectively, and al the patients obtained the satisfactory clinical effect;the Harris score of the youth group was increased to (88.1±0.9) points, and the visual analog scale score was decreased to (0.9±0.4) points;the Harris score of the elderly group was increased to (91.5±1.0) points, and the visual analog scale score was decreased to (0.60±0.07) points. The results indicate that vascularized greater trochanter or iliac periosteal flap displacement is suitable for the children and the youths with femoral head avascular necrosis, especial y the patients with the age of 15-45 years in Ficat Ⅱ and Ⅲstage;hybrid or cementless total hip arthroplasty is suitable for the elder patients with femoral head avascular necrosis, as wel as the patients with failure femoral head retention treatment.