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Percutaneous autologous impaction bone graft for advanced femoral head osteonecrosis: a retrospective observational study of unsatisfactory short-term outcomes.
- Source :
-
Journal of orthopaedic surgery and research [J Orthop Surg Res] 2021 Feb 17; Vol. 16 (1), pp. 141. Date of Electronic Publication: 2021 Feb 17. - Publication Year :
- 2021
-
Abstract
- Background: Half of osteonecrosis of the femoral head (ONFH) patients suffer femoral head collapse at initial diagnosis, and more than half are bilaterally affected. This study developed a percutaneous autologous impaction bone graft (IBG) technique as a modification of core decompression (CD). We also summarized the short-term results and treatment efficacy of percutaneous autologous IBG in advanced ONFH.<br />Methods: Twenty patients (12 males, 8 females) with nontraumatic, postcollapse ONFH except one case underwent CD (10-mm core diameter) and reverse IBG. Radiological changes of the ONFH stage and type were analyzed. Survival analysis using Kaplan-Meier estimates was performed with conversion to total hip arthroplasty (THA) as the endpoint. In addition, the Harris hip score (HHS) and University of California, Los Angeles (UCLA) activity rating scale were evaluated.<br />Results: Percutaneous autologous IBG was performed successfully, with an average operation time of < 1 h and small blood loss, and 7 patients (35%) needed conversion to THA at an average of 17 months postoperatively. We observed radiological progressive change in 60% of the patients during a mean observation period of 3 years. The mean clinical scores, except data recorded, after THA significantly improved (before vs. after 3 years: UCLA activity score, 3.7 vs. 5.2 [P = 0.014]; HHS, 57.6 vs. 76.5 points [P = 0.005]). In addition, 6 patients showed radiological progression but no clinical deterioration.<br />Conclusions: Percutaneous autologous IBG was technically simple and minimally invasive, but short-term results were unsatisfactory for advanced ONFH. Indications for this procedure should be carefully examined to improve it in order to enable bone formation.
- Subjects :
- Adult
Bone Regeneration
Disease Progression
Female
Femur Head diagnostic imaging
Femur Head physiopathology
Humans
Male
Middle Aged
Osteogenesis
Osteonecrosis diagnostic imaging
Osteonecrosis physiopathology
Retrospective Studies
Severity of Illness Index
Time Factors
Young Adult
Arthroplasty, Replacement, Hip methods
Autografts
Bone Transplantation methods
Femur Head surgery
Minimally Invasive Surgical Procedures methods
Osteonecrosis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1749-799X
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic surgery and research
- Publication Type :
- Academic Journal
- Accession number :
- 33596957
- Full Text :
- https://doi.org/10.1186/s13018-021-02288-7