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Clinical study on minimally invasive treatment of femoral head necrosis with two different bone graft materials

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Abstract

Purpose

To investigate the clinical efficacy and safety of two different bone graft materials in the minimally invasive treatment of early and middle stage femoral head necrosis.

Methods

A total of 36 patients (39 hips) with avascular necrosis of the femoral head were divided into autologous iliac bone group (ABG) and bioceramics bone group (BBG). Both groups were treated with minimally invasive thick channel decompression to remove dead bone of femoral head. The ABG was treated with autologous iliac bone graft, and BBG was treated with β-tricalcium phosphate bone graft. The operation time, intra-operative blood loss, haemoglobin, and haematocrit were recorded at three and seven days post-operatively. The clinical efficacy and safety were evaluated by Harris score and imaging examination before, and after treatment and at follow-up stages.

Results

The patients were followed up for 24 to 45 (average 29.27 ± 3.56) months. The BBG was significantly better than the ABG in terms of operation time, intra-operative blood loss, haemoglobin, and haematocrit value at three days. Compared with pre-operative, the Harris score of the two groups at 12 months after operation was significantly improved. The Harris score and the imaging evaluation of the last follow-up exhibited significantly better outcome in BBG than those of ABG.

Conclusion

Bioceramics and autologous iliac bone minimally invasive treatment of early and medium-term femoral head necrosis exhibited satisfactory clinical efficacy in the short and medium-term. The bioceramics graft materials have the advantages of reducing trauma, bleeding, operation time, and quick recovery of post-operative functions.

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Acknowledgments

We thank Juntao Zhang,Dawei Liang, Haonan Ling, Ying Zhang, Youwen Liu, and Xiantao Chen for their assistance in the case collection, data statistical analysis, and the study program design. The sponsors and funders had no role in the inception or design of the study, data collection and analysis, or preparation of this report.

Funding

This study was supported by the medical and health projects of Luoyang science and technology plan (1603004A-8) and the special subject of scientific research on traditional Chinese medicine in Henan Province (2019ZY2081).

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Author notes

  1. Leilei Zhang and Juntao Zhang contributed equally to this work.

Authors and Affiliations

  1. Research and treatment center of hip injury diseases, Medical Center of Hip, Luoyang Orthopedic Hospital of Henan Province, Orthopedics Hospital of Henan Province, No. 82, South Qiming Road, Luoyang, 471002, China

    Leilei Zhang, Dawei Liang, Haonan Ling, Ying Zhang, Youwen Liu & Xiantao Chen

  2. Henan University of Traditional Chinese Medicine, Zhengzhou, China

    Juntao Zhang

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  1. Leilei Zhang
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Correspondence to Leilei Zhang.

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Zhang, L., Zhang, J., Liang, D. et al. Clinical study on minimally invasive treatment of femoral head necrosis with two different bone graft materials. International Orthopaedics (SICOT) 45, 585–591 (2021). https://doi.org/10.1007/s00264-020-04916-z

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  • DOI: https://doi.org/10.1007/s00264-020-04916-z

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