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[Clinical application of minimally invasive core decompression combined with impaction bone grafting to the treatment of femoral head necrosis].

OBJECTIVE
To explore a simple,effective threrapeutic method for the treatment of ischemia necrosis of femoral head.


METHODS
From March 2003 to April 2008, 61 hips of 55 patients, including 37 males and 18 females, aged from 12 to 55 years old (averaged 39.8), with ischemia necrosis of femoral head were treated by three methods combination of partial synovectomy, minimally invasive core decompression and impaction bone grafting. The course of diseace was from 8 months to 16 years. The therapeutic effects were evaluated according to the preoperative and postoperative X-ray and Harris scoring for hip funtion.


RESULTS
These 55 patients (61 hips) were followed up for from 6 mouths to 5 years (means 2.2 years). X-ray results showed that collapse or aggrevation occurenced in 39 hips,the aggravation of collapse no more than 2 mm in 11 hips,the collapse from 2 to 4 mm in 9 hips, the collapse surpassed 4 mm in 2 hips. Harris scores increased obviously from preoperative (59.74 +/- 11.56) points to postoperative (89.75 +/- 9.58) points (t = 2.3461, P < 0.05). The results were excellent in 31 hips, good in 22 hips, fair in 6 hips and poor in 2 hips.


CONCLUSION
Minimally invasive core decompression combined with impaction bone grafting can reduce the stress load of femoral head, stabilized the environment of femoral head,promote osteonecrotic bone rapairing and prevent effectively the femoral head form collapsing. This method can be applied to femoral head necrosis at Ficat II, III stage, especially for young and middle-age patients.