Endoscopic observation finding in the core decompression procedure of osteonecrosis of femoral head and effect of additi
- PDF / 2,548,560 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 38 Downloads / 237 Views
ORIGINAL PAPER
Endoscopic observation finding in the core decompression procedure of osteonecrosis of femoral head and effect of additional treatments Hyon Pak 1 & Song Gun Ri 2 & Myong Guk Jang 2 & Sung Jae Kim 3 Received: 17 October 2020 / Accepted: 22 October 2020 # SICOT aisbl 2020
Abstract Purpose To observe necrotic findings of the femoral head through the endoscopic examination when performing the decompression procedure widely used in the treatment of osteonecrosis of femoral head. To assess the efficacy of injection of bone marrow aspirated from the iliac crest and new vascularized bone graft into the core of femoral head based on the endoscopic findings. Methods The first stage of osteonecrosis of femoral head based on ARCO classification includes 23, second stage 36, and third stage eight femoral heads. Bone marrow transplantations have been performed in 49 hip joints and new vascularized bone grafts in 18 hip joints. Results The endoscopic findings of osteonecrosis of femoral heads are varied, and they can be divided into five categories. The average time in core decompression and bone marrow injection was 15 minutes, and the average time of new pedicled bone grafts was 65 minutes (45–90 minutes). The efficacy of bone marrow injection was 93.88%, and the efficacy of vascularized bone graft was 94.44% when performed based on the endoscopic findings. Conclusion It is possible to increase the treatment efficacy of the osteonecrosis of the femoral head when appropriate additional treatments are applied based on endoscopic findings in the decompression procedures of pre-collapse osteonecrosis of the femoral head. Keywords Osteonecrosis . Endoscopic . Bone marrow . Bone grafts
Introduction It is better to preserve the femoral head than replace it, especially in young patients. The core decompression at precollapse osteonecrosis of the femoral head is minimally invasive and has some effects, so that now it became a common surgical procedure in clinical practice. The core decompression treatment is more effective when performed in combination with other treatments. Osteogenic progenitor cells and
* Hyon Pak [email protected]
growth factors in the buffy coats aspirated from the bone marrow of the iliac crest have been reported to be applied into the core of the femoral head after the decompression. This method shows good results when applied for pre-collapse osteonecrosis of femoral head and should be considered the primary option for the treatment of osteonecrosis of the hip. The most effective treatment appears to be a vascularized fibular grafting. In practice, ideal bone graft should be provided to support subchondral area of femoral head and assure the contact between bone graft and core walls.
Materials and methods Patients
1
Department of Microsurgery and Plastic Surgery, HyeSan Medical College, HyeSan, Korea
2
Department of Microsurgery and Plastic Surgery, Pyongyang University of Medical Sciences, Pyongyang, Korea
3
Pyongyang University of Medical Sciences, Pyongyang, Korea
Early diagnosis
Data Loading...
