Efficacy and Safety Analysis of Core Decompression Using Percutaneous Expandable Reamer Combined with PRO-DENSE Renewable Bone Graft-ing for the Treatment of Femoral Head Necrosis
HAO Zhipeng
WU Tao
LI Xiaohua
LIU Yongqiang
Abstract：Objective To explore the application value of core decompression using percutaneous expandable reamer combined with PRO-DENSE renewable bone grafting in the treatment of osteonecrosis of the femoral head(ONFH).Methods A total of 100 patients with ONFH treated from January 1,2020 to January 1,2022 were retrospectively selected and divid-ed into two groups with 50 cases in each group according to the surgical method.The control group underwent core decompres-sion and autogenous bone grafting,and the observation group underwent core decompression using percutaneous expandable reamer combined with PRO-DENSE regenerated bone grafting.Surgical observation indexes,surgical efficacy and complica-tions were compared between the two groups.Neurogenic inflammatory markers[nerve growth factor(NGF),prostaglandin E2(PGE2)],serum biochemical markers[hypoxia-inducible factor-1 α(HIF-1α),vascular endothelial growth factor A(VEGF-A),procollagen typeⅠN-propeptide(PⅠNP),osteocalcin(BGP)],visual analogue scale(VAS)score and Har-ris hip function score before and after operation were compared between the two groups.Results The intraoperative blood loss in the observation group[(24.25±4.78)mL]was less than that in the control group[(50.29±8.94)mL],and the length ofhospitalization[(12.50±2.24)d]was shorter than that in the control group[15.12±3.37)d](P＜0.01).Serum NGF and PGE2 in the observation group were lower than those in the control group at 1,3 and 7 d after operation(P＜0.05).Serum HIF-1α,VEGF-A,BGP and Harris hip function scores in observation group were higher than those in control group at 1,3 and 6 months after operation,while serum PⅠNP and VAS scores were lower than those in control group(P＜0.05).There was no significant difference in the excellent and good rate of operation and total incidence of complications between the two groups(P＞0.05).Conclusion Core decompression using percutaneous expandable reamer combined with PRO-DENSE regenerative bone grafting is a safe and reliable treatment for patients with ONFH,which can reduce the level of in-flammatory factors,promote early postoperative recovery,accelerate bone metabolism,promote hip function recovery,and al-leviate patients'pain.
Keywords：Femoral head necrosisCore decompressionAutogenous bone graftingExpandable reamerPRO-DENSE renewable bone graftingNerve growth factorPainVascular endothelial growth factor A
Publication Date：2024-05-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 36-41 )