Comparison of Intramedullary Decompression with Bone Graft Bone and Flap Muscle Sartorious Transfers in Treatment of Ficat-Ⅲ Femoral Head Avascular Necrosis

Abstract：Objective To compare the long-term follow-up results of intramedullary decompression with bone graft bone and flap muscle sartorious transfers in treatment of Ficat-Ⅲfemoral head avascular necrosis. Methods we retrospectively ananlyzed 38 cases(43 hips)of Ficat-Ⅲ femoral head avascular necrosis treated with intramedullary decompression with bone graft bone and flap muscle sartorious transfers between January 2003 and December 2008. The related data,intraoperative blood loss,surgical time and hospital days were compared. The outcomes were assessed clinically according to changes in the Harris hip score. The hip survival analysis were conducted with the Kaplan-Meier method. Results All cases were followed up 60 to 123 months. There was no significant difference between the two groups according to their age,duration of follow-up and preoperative Harris hip scores(P ﹥0. 05). The Harriss core of both groups was obviously increased postoperatively(P ﹤0. 05). The blood loss,surgical time and hospital days of intramedullary decompression with bone graft group were significantly less than flap muscle sartorious transfers group( P ﹤0. 01). The postoperative Harris scorees of intramedullary decompression group were higher than intramedullary decompression with bone graft group(P ﹤0. 05). There was no significant radiological difference in the results of both surgical techniques( P ﹥ 0. 05). Kaplan-Meier survivorship curves showed that the survival rate in the two groups were 64%(16/25)and 77. 8%(14/18)respectively. There was no significant difference between the two groups according to the long-term survival rate(P ﹥0. 05). Conclusion There is certain clinical curative effect in the two groups treated by intramedullary decompression with bone graft bone and flap muscle sartorious transfers. Although there was no significant radiological and survival difference in the long-term results of both surgical techniques,the clinical results of flap muscle sartorious transfers were significantly better than the results of intramedullary decompression with bone graft bone.