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Minimally invasive treatment for osteonecrosis of the femoral head with angioconductive bioceramic rod

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Abstract

Purpose

To describe the rationale, the surgical technique, and the short-term follow-up results of a new minimally invasive treatment of osteonecrosis of the femoral head (ONFH) with an angioconductive bioceramic rod (ABR) implant.

Methods

Sixty-two patients (72 hips) with ARCO stage IIA-IIIC ONFH treated with the minimally invasive ABR from January 2012 to December 2016 were reviewed (17 females, 45 males, mean age 44.49). This technique used the angioconductive properties of the porous implant to repair the necrosis by driving vascularization from the trochanter to the necrotic area. Patients had a mean follow-up period of 26.74 months. The outcomes were evaluated by hip joint survival, radiograph, and the Harris Hip Score (HHS). The complications occurred during the treatment period were recorded.

Results

No serious post-operative complications occurred during the treatment. The overall joint survival rate was 90.27%, with seven conversions to THA. Improvements were observed in 23 (31.95%) hips, 24 (33.33%) hips remained stable, and 25 (34.72%) hips had worse results according to the radiographic evaluation. The mean HHS at the end follow-up significantly improved compared to the pre-operative mean HHS (82.27 vs 58.14, p < 0.001). In both radiographic evaluation and HHS, the treatment was more effective on patients beneath 44 years old (p < 0.05); ARCO stage II compared to stage III (p < 0.05); and China-Japan Friendship Hospital (CJFH) type C compared to CJFH type L (p < 0.05).

Conclusions

The minimally invasive treatment of ONFH with ABR showed promising results in delaying or even terminating the progression of the necrosis and improving hip function, especially in younger patients and in the early stages of the disease.

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Funding

This study was supported by the Shanghai Technology Innovation project (No. 15441902800).

Author information

Author notes

  1. Yajie Lu, Xiao Lu and Minghui Li contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Xijing Hospital, The Air Force Military Medical University, No. 15 Changle West Road, Xi’an, Shaanxi, China

    Yajie Lu, Minghui Li & Zhen Wang

  2. School of Materials Science and Engineering, South China University of Technology, No.381 Wuhan Road, Guangzhou, Guangdong, China

    Xiao Lu

  3. Luoyang Orthopedic Hospital of Henan Province, No. 82 Qiming South Road, Luoyang, Henan, China

    Xiantao Chen & Youwen Liu

  4. Central Hospital of Songyuan City, No.1188 Wenhua Road, Songyuan, Jilin, China

    Xianfa Feng

  5. Second People’s Hospital of Jiaozuo City, No.17 Minzhu South Road, Jiaozuo, Henan, China

    Jinwei Yu

  6. Central Hospital of Hanzhong City, No. 22 Kangfu Road, Hanzhong, Shaanxi, China

    Chengquan Zhang

  7. Ningxia People’s Hospital, No. 301 Zhengyuan North Road, Yinchuan, Ningxia, China

    Dongsheng Niu

  8. Huashan Hospital of Fudan University, No.12 Urumqi Middle Road, Shanghai, China

    Siqun Wang

  9. Shanghai Bio-lu Biomaterials Co., Ltd., No.188 Xinjunhuan Road, Shanghai, China

    Jianxi Lu

Authors
  1. Yajie Lu
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  2. Xiao Lu
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  3. Minghui Li
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  4. Xiantao Chen
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  5. Youwen Liu
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  6. Xianfa Feng
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  7. Jinwei Yu
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  8. Chengquan Zhang
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  9. Dongsheng Niu
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  10. Siqun Wang
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  11. Zhen Wang
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  12. Jianxi Lu
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Corresponding authors

Correspondence to Zhen Wang or Jianxi Lu.

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The authors declare that they have no conflict of interest.

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Cite this article

Lu, Y., Lu, X., Li, M. et al. Minimally invasive treatment for osteonecrosis of the femoral head with angioconductive bioceramic rod. International Orthopaedics (SICOT) 42, 1567–1573 (2018). https://doi.org/10.1007/s00264-018-3919-6

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  • DOI: https://doi.org/10.1007/s00264-018-3919-6

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