EFFICACY OF CORE DECOMPRESSION AND AUTOLOGOUS CANCELLOUS BONE GRAFTING IN AVASCULAR NECROSIS OF FEMORAL HEAD

2021 ◽  
pp. 108-110
Author(s):  
Vimal kumar bairwa ◽  
Pradeep Singh ◽  
Rakesh verma ◽  
Shivbhagwan sharma ◽  
Arvind kumar bohra
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Cancellous Bone ◽  
Bone Grafting ◽  
Core Decompression ◽  
Harris Hip Score ◽  
Age Group ◽  
Cancellous Bone Grafting ◽  
Autologous Bone Grafting ◽  
Autologous Bone

BACKGROUND: Avascular necrosis (AVN) of the femoral head is a disease that usually affects patients in the 20-50 year age group of life. The disease progresses with time and if left untreated, it may leads to complete deterioration of the hip joint. Various treatments modalities are available as non-surgical, core decompression alone or with autologous bone graft or PRP or bone marrow aspirate or vascularised bular graft, osteotomies and hip replacement. We planned to evaluate the efcacy of core decompression and autologous bone grafting in the management of AVN of the hip. MATERIALS AND METHODS- We performed a prospective study with 20 patients of 20-50 years age group having cat-arlet stage 1 [8 patients ] and 2a [12 patients]. The study period was from January 2018 to December 2019. All patients were treated with core decompression and autologous cancellous bone grafting. Pre-operative Harris hip score [HHS], plain radiograph and MRI were compared with postoperative ones at different time intervals. RESULTS- Average Follow Up Period Was 12 Months And Average Age Group Of Presentation Was 31.1 Years . Males Were More Affected And Most Common Causes Were Idiopathic And Steroid Use. Average Preoperative Hhs Was 56.20 And Postoperative Hhs Was 80.15. At The End Of 1 Year, 12 Patients Showed Remission, 6 Patients Showed Preoperative Stage While 2 Patients Progressed To Advanced Stage And Required Arthroplasty. CONCLUSION-core Decompression And Autologous Bone Grafting Is Effective Treatment Modality In Early Avascular Necrosis Of Femur Head In Terms Of Radiological And Clinical Results And Delaying Arthroplasty

scholarly journals Autologous Stem Cells Combined Core Decompression for Treatment of Avascular Necrosis of the Femoral Head: A Systematic Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Shibing Xu ◽  
Lei Zhang ◽  
Hongting Jin ◽  
Letian Shan ◽  
Li Zhou ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Core Decompression ◽  
Autologous Bone Marrow ◽  
Bone Marrow Stem Cells ◽  
Harris Hip Score ◽  
Autologous Bone

Objective. This study aims to systematically evaluate the efficacy and safety of core decompression combined transplantation of autologous bone marrow stem cells (CDBMSCs) for treatment of avascular necrosis of the femoral head (ANFH). Methods. Randomized controlled trials (RCTs) regarding effectiveness of core decompression combined transplantation of autologous bone marrow stem cells for treating ANFH were searched in 8 comprehensive databases prior to September 2016. The data analysis was performed by using the RevMan version 5.3. Results. A total of 11 studies with 507 participants were included. Results showed that CDBMSCs group was more effective than CD group in increasing Harris hip score, decreasing necrotic area of femoral head, collapse of femoral head, and conversion to total hip replacement incidence. In the subgroup analysis, the results did not change in different intervention measure substantially. In addition, the safety of CDBMSCs for ANFH is reliable. Conclusion. Based on the systematic review, our findings suggest that core decompression combined transplantation of autologous bone marrow stem cells appeared to be more efficacious in the treatment at early stages of ANFH.

scholarly journals Management of avascular necrosis of femoral head by core decompression

2018 ◽  
Vol 4 (3) ◽  
pp. 497
Author(s):  
Amol Sanap ◽  
Yash B. Rabari ◽  
Vijay Teja ◽  
Siddharth Shah
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Bone Grafting ◽  
Core Decompression ◽  
Rural Hospital ◽  
Harris Hip Score ◽  
Bilateral Involvement ◽  
Study Results ◽  
Necrosis Of Femoral Head ◽  
Grade Iii

<p class="abstract"><strong>Background:</strong> Avascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. The head of femur is the most common bone affected by avascular necrosis. Our aim is to study results of core decompression and bone grafting in avascular necrosis of femoral head.</p><p class="abstract"><strong>Methods:</strong> The present study was performed at Pravara Rural Hospital, a constituent hospital of Rural Medical Collage at Village Loni, Rahta and district: Ahamadnagar. The study includes patients who underwent core decompression and bone grafting in avascular necrosis of femoral head at Department of Orthopaedics, Pravara Rural Hospital from June 2015 to June 2017.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study majority of the patients belongs to the group of 31-40 years and most of them were males. Male female ratio was 4:1. Out of 20 patients, 6 of them were unilaterally involved rest 14 had bilateral involvement. Out of 28 hips of bilateral involvement 6 were grade III and IV Ficat and Arlet. That 6 were not considered as they come in grade III &amp; IV of FICAT &amp; ARLET classification. So we study 28 hips only.</p><p class="abstract"><strong>Conclusions:</strong> The average success rate was 82.61% after core decompression and bone grafting. The patients who had less than 60 Harris hip score on presentation had poorer outcome. Patients who had less than 80 degrees of flexion had also poorer outcome.</p><p class="abstract"> </p>

scholarly journals OSTEONECROSIS OF FEMORAL HEAD: OUTCOME OF CORE DECOMPRESSION WITH CANCELLOUS BONE GRAFTING.

2017 ◽  
Vol 5 (4) ◽  
pp. 1773-1777
Author(s):  
Arvind Kumar ◽  
◽  
Sudhirkumar Rawat ◽  
Parth Deshmukh ◽  
Ajay Mandloi ◽  
...  
Keyword(s):  
Femoral Head ◽  
Cancellous Bone ◽  
Bone Grafting ◽  
Core Decompression ◽  
Cancellous Bone Grafting ◽  
Osteonecrosis Of Femoral Head

Local Cancellous Bone Grafting for Osteonecrosis of the Femoral Head

2008 ◽  
Vol 16 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Yuhan Chang ◽  
Chi-Chien Hu ◽  
Dave W. Chen ◽  
Steve W. N. Ueng ◽  
Chun-Hsiung Shih ◽  
...  
Keyword(s):  
Femoral Head ◽  
Cancellous Bone ◽  
Bone Grafting ◽  
Cancellous Bone Grafting

Outcomes and indications of the single approach to double-channel core decompression and bone grafting with structural bone support for osteonecrosis of the femoral head

2021 ◽  
Author(s):  
Ju’an Yue ◽  
Xiaozhong Guo ◽  
Randong Wang ◽  
Bing Li ◽  
Qiang Sun ◽  
...  
Keyword(s):  
Femoral Head ◽  
Bone Grafting ◽  
Early Stage ◽  
Core Decompression ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Femoral Head Collapse ◽  
Double Channel ◽  
Single Approach

Abstract BackgroundTo report the outcomes of the single approach to double-channel core decompression and bone grafting with structural bone support (SDBS) for osteonecrosis of the femoral head (ONFH) and define the indications.MethodsOne-hundred-and-thirty-nine hips in 96 patients (79 males, 17 females; mean age 37.53±10.31 years, range 14–58 years; mean body mass index 25.15±3.63 kg/m2) were retrospectively analysed. The Harris hip score (HHS) was used to assess hip function, and radiographs were used to assess the depth of femoral head collapse. Treatment failure was defined as the performance of total hip arthroplasty (THA). The variables assessed as potential risk factors for surgical failure were: aetiology, Japanese Osteonecrosis Investigation Committee (JIC) type, age, and Association Research Circulation Osseous (ARCO) stage. Complications were recorded.ResultsThe HHS increased from 79.00±13.61 preoperatively to 82.01±17.29 at final follow-up (P=0.041). The average HHS improvement was 3.00±21.86. The combined excellent and good rate at final follow-up (65.6%) was significantly higher than that before surgery (34.5%) (P=0.000). On radiographic evaluation, 103 (74.1%) hips remained stable, while 36 (25.9%) had femoral head collapse or aggravation of ONFH. THA was performed in 18 hips. Thus, the overall femoral head survival rate was 87.05% (121/139). The success rate was adversely affected by JIC type, but not by aetiology, age, or ARCO stage. The only complication was a subtrochanteric fracture in one patient.ConclusionThe SDBS effectively delays or even terminates the progression of ONFH, especially type B and C1. The SDBS is a good option for early-stage ONFH.

A MODIFIED DECOMPRESSION AND BONE GRAFT TECHNIQUE FOR THE TREATMENT OF AVASCULAR NECROSIS OF THE FEMORAL HEAD

2016 ◽  
Vol 19 (01) ◽  
pp. 1650005
Author(s):  
Ahmad M. Shehadeh ◽  
Samer Abed El Al ◽  
Ahmad Ja’far ◽  
Ahmad Salem ◽  
Imad Abo Shahin ◽  
...  
Keyword(s):  
Pain Relief ◽  
Femoral Head ◽  
Bone Graft ◽  
Avascular Necrosis ◽  
Core Decompression ◽  
Stage I ◽  
Harris Hip Score ◽  
Graft Material ◽  
Modified Technique ◽  
Average Operative Time

Objectives: Avascular necrosis (AVN) of the femoral head is a pathologic process resulting from interruption of blood supply to bone. The aim of this paper is to describe the technical aspects and outcome of a modified technique of core decompression and bone graft injection for the treatment of AVNFH. Methods: A total of 20 patients (26 femoral head AVN) Ficat stage I to early III were treated using core decompression kit followed by injection with bone graft material. Nine hips were stage III, 16 stage II and 1 stage I. Average operative time was 25[Formula: see text]min. Results: At a median follow-up of 48 months, 20 hips (77%) had almost complete pain relief while pain persisted in 6 hips (23%). All patients who demonstrated clinical response exhibited radiological stabilization of disease. The mean Harris hip score for all patients’ prior and following surgery were 41 and 85, respectively ([Formula: see text]). Conclusions: Femur head decompression using core decompression kit followed by bone substitute injection can result in long-term pain relief and prevent progression of AVN in the majority of patients.

scholarly journals Repair of non-traumatic femoral head necrosis by marrow core decompression with bone grafting and porous tantalum rod implantation

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Keyun Peng ◽  
Yu Wang ◽  
Jifeng Zhu ◽  
Chengling Li ◽  
Zimin Wang
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Bone Grafting ◽  
Core Decompression ◽  
The Other ◽  
Femoral Head Necrosis ◽  
Clinical Effects ◽  
Porous Tantalum ◽  
Creative Commons ◽  
Significant Difference

Objective: To compare the clinical effects of marrow core decompression with bone grafting and marrow core decompression with porous tantalum rod implantation in treating avascular necrosis of non-traumatic femoral head. Methods: This prospective study selected 60 patients (74 hips) with avascular necrosis of femoral head admitted to Daping Hospital from January 2018 to March 2019. According to treatment methods, the 60 patients were randomly divided into two groups, i.e. 30 patients in one group were treated by marrow core decompression with bone grafting, and the other 30 patients in the other group were treated with marrow core decompression and porous tantalum rod implantation. Results: All implantation treatments were successful. No significant difference was found in surgical duration, hemorrhage volume and duration of hospitalization stay between the two groups during follow-up. All Harris scores were significantly improved (P<0.05) following treatment compared to those before treatment. The Harris score of patients treated with porous tantalum rod implantation was higher than that of patients treated with bone grafting (P<0.05) after 12 months following treatment and such a difference was significant. Conclusion: The combination of marrow core decompression and porous tantalum rod implantation can better improve the functions of hip joints with early femoral head necrosis than marrow core decompression with bone grafting, and can also prevent articular cartilage from collapsing gradually. doi: https://doi.org/10.12669/pjms.36.6.2176 How to cite this:Peng K, Wang Y, Zhu J, Li C, Wang Z. Repair of non-traumatic femoral head necrosis by marrow core decompression with bone grafting and porous tantalum rod implantation. Pak J Med Sci. 2020;36(6):1392-1396. doi: https://doi.org/10.12669/pjms.36.6.2176 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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