Abstract：Objective To explore the effectiveness and related analysis of precise minimally invasive treatment for traumatic avascular necrosis of femoral head(ANFH) in soldiers.Methods Seventy-seven cases(93 hips) admitted in the Orthopedics Department of the Third Medical Center of PLA General Hospital from Feb.2014 to Apr.2018 were randomly divided into the group of extracorporeal shock wave (control group; 46 hips) and the group of precise drilling decompression combined with shock wave therapy under hip arthroscopy (combined treatment group; 47 hips). Visual Analogue score and Harris Hip score were used to evaluate the pain and hip function of both groups at the time of before treatment, 3, 6 months and the last followed-up visit after treatment, and Kaplan-Meier survival curve was used to record the collapse and survival time of femoral head of the two groups.Results The mean time follow-up visit was 72 months, and there was no statistically significant comparison of subjective pain and functional evaluation of the hip joint before treatment between the two groups, while those evaluation indicators at 3, 6 months and the last follow-up visit after treatment were significantly better in combined treatment group. The excellent rate(85.11％),femoral head collapse and survival time were also significantly better in combined treatment group, with statistically significant differences(χ2=6.948, P=0.016).Conclusions The efficacy of guided microscopic precision drilling decompression combined with shock wave is more satisfactory than shock wave treatment alone for hip function and can delay the femoral head collapse in soldiers with ARCO stage I-IIIA ANFH.
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2022, Vol. 33 
