Abstract:Objective To evaluate the therapeutic effect of MRI-guided core decompression against osteonecrosis of the femoral head. Methods A total of 32 patients who were diagnosed with ONFH at the Third Medical Center of the PLA General Hospital in 2016 were selected. The general information about these patients was collected to ensure that they had no contraindications to surgery before they were subjected to epidural anesthesia and surgery. The visual analogue scale (VAS) and Harris score were used to analyze the effect.MRI was used to observe the size and position of the necrotic area. Results The preoperative VAS score was 5.52±1.14, and Harris total score was 35.8±5.89 (pain 15.26±3.11; function 17.70±4.83; stiffness 2.84±1.95). The VAS score after 6 months was 4.59±0.5, and Harris total score was 62.0±5.42 (pain 29.76±3.27; function 29.06±4.47; stiffness 5.18±1.42), compared with 2.55±0.5 and 80.77±3.78 (pain 37.94±3.02; function 38.4±2.27; stiffness 7.43±1.13) after twelve months. There was statistically significant difference between the preoperative scores and postoperative ones (P<0.05). Conclusions MRI-guided core decompression used for osteonecrosis of the femoral head is technically feasible, accurate and safe. Patients with early osteonecrosis may benefit from such treatment.
Sobhan M R, Mahdinezhad Y M, Moghimi M, et al. Plasminogen activator inhibitor-1 4 g/5 g polymorphism contributes to osteonecrosis of the femoral head susceptibility: evidence from a systematic review and meta-analysis [J]. Arch Bone Jt Surg, 2018, 6(6): 468-477.
[2]
Zhang Q Y, Li Z R, Gao F Q, et al. Pericollapse stage of osteonecrosis of the femoral head: a last chance for joint preservation [J]. Chin Med J (Engl), 2018, 131(21): 2589-2598.
[3]
Zhang Q, Yang F, Chen Y, et al. Chinese herbal medicine formulas as adjuvant therapy for osteonecrosis of the femoral head: a systematic review and meta-analysis of randomized controlled trials [J]. Medicine (Baltimore), 2018, 97(36): e12196.
[4]
Basal O, Atay T, Ciris I M, et al. Epidermal growth factor (EGF) promotes bone healing in surgically induced osteonecrosis of the femoral head (ONFH) [J]. Bosn J Basic Med Sci, 2018, 18(4): 352-360.
[5]
Auregan J C, Villain B, egue T B. What is the rate of patients undergoing a total hip arthroplasty after core decompression and insertion of a tantalum rod in osteonecrosis of the femoral head: a systematic review [J]. Int Orthop, 2018, 42(7): 1631-1638.
[6]
Calori G M, Mazza E, Colombo A, et al. Core decompression and biotechnologies in the treatment of avascular necrosis of the femoral head [J]. EFORT Open Rev, 2017, 2(2): 41-50.
Ahrar K, Sabir S H, Yevich S M, et al. MRI-Guided interventions in musculoskeletal system[J]. Top magn reson imaging, 2018, 27(3): 129-139.
[9]
Wang T, Azeddine B, Mah W, et al. Osteonecrosis of the femoral head: genetic basis [J]. Int Orthop, 2019, 43(3): 519-530.
[10]
Wang J, Wang J, Zhang K, et al. Bayesian network meta-analysis of the effectiveness of various interventions for nontraumatic osteonecrosis of the femoral head [J]. Int Orthop, 2018,18:2790163.
[11]
Luo P, Gao F, Han J, et al. The role of autophagy in steroid necrosis of the femoral head: a comprehensive research review [J]. Int Orthop, 2018, 42(7): 1747-1753.
[12]
Wu J Q, Mao L B, Wu J. Efficacy of balance training for hip fracture patients: a meta-analysis of randomized controlled trials [J]. J Orthop Surg Res, 2019, 14(1): 83.
[13]
Cohen R A, Cui Q. Osteonecrosis of the femoral head [J]. Orthop Clin North Am, 2019, 50(2): 139-149.
Sultan A A, Mont M A. Core decompression and bone grafting for osteonecrosis of the talus: a critical analysis of the current evidence [J]. Foot Ankle Clin, 2019, 24(1): 107-112.