Comparison of two joint-preserving treatments for osteonecrosis of the femoral head: core decompression and core decompression with additional cancellous bone grafting

Woerner, Michael and Voelkl, Korbinian and Bliemel, Christopher and Ferner, Felix and Weber, Markus and Renkawitz, Tobias and Grifka, Joachim and Craiovan, Benjamin (2023) Comparison of two joint-preserving treatments for osteonecrosis of the femoral head: core decompression and core decompression with additional cancellous bone grafting. JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, 51 (8): 0300060523. ISSN 0300-0605, 1473-2300

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Abstract

ObjectiveFemoral head necrosis (FHN) affects mostly young and active people. The most common operative therapy is core decompression (CD) with optional cancellous bone grafting (CBG). Because little information is available on the long-term results of these procedures, we investigated the effectiveness of CD and CD + CBG in patients with ARCO stage II FHN in terms of postoperative pain, range of motion, patient-reported outcome measures (Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score, EuroQol 5D, and Short Form 36 Questionnaire), and disease progression. MethodsWe retrospectively compared 11 patients treated with CD alone 48.0 months (range, 26.3-68.5 months) postoperatively versus 11 patients treated with CD + CBG 69.2 months (range, 38.0-92.9 months) postoperatively. All patients were assessed according to a routine clinical protocol involving a clinical examination, questionnaires, and radiological imaging (X-ray and magnetic resonance imaging). ResultsThe clinical and radiological results showed no significant differences between the two groups. Both interventions demonstrated equal results according to clinical scores. ConclusionsOur data may encourage application of the less invasive technique of CD alone without CBG, which is more surgically demanding. Further prospective studies with longer follow-up are necessary to clarify the risk factors for therapy failure.

Item Type: Article
Uncontrolled Keywords: MARROW EDEMA SYNDROME; AVASCULAR NECROSIS; NONTRAUMATIC OSTEONECROSIS; INDUCED ADIPOGENESIS; STEM-CELLS; HIP; MANAGEMENT; MECHANISM; COLLAPSE; Hip; femoral head necrosis; joint-preserving therapy; core decompression; cancellous bone grafting; patient-reported outcome; long-term outcome
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Orthopädie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 14 Mar 2024 10:03
Last Modified: 14 Mar 2024 10:03
URI: https://pred.uni-regensburg.de/id/eprint/60055

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