Feasibility analysis of early femoral head necrosis treated with improved core decompression and bone grafting surgery combined with porous tantalum rod material

Dang Haifeng; Fan Junjun; Yang Chao; Hao Zhilong; Xue Baobao; Shi Lei

doi:10.3760/j.issn.1673-4777.2024.03.020

Abstract：Objective To explore the feasibility of early femoral head necrosis(ONFH)treated with improved core decompression and bone grafting surgery combined with porous tantalum rod material.Methods Totally 72 patients(72 hips)with early ONFH admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2021 to October 2022 were selected as the study subjects.They were divided into control group and observation group by the random number table method,with 36 cases in each group.The control group received conventional core decompression and bone grafting surgery treatment,while the observation group received improved core decompression and bone grafting surgery combined with porous tantalum rod material.The perioperative indicators,preoperative and postoperative visual analogue scale(VAS)score,Fugl-Meyer balance scale(FMA)score,Harris hip joint function score,hip joint range of motion,clinical efficacy,and postoperative complications of the two groups were compared.Results The surgical time,intraoperative bleeding,and fracture healing time in the observation group were shorter/less than those in the control group[(51±17)min vs(62±15)min,(103± 26)ml vs(135±36)ml,(11.5±1.6)weeks vs(13.2±2.6)weeks],and the differences were statistically significant(all P＜0.05).After 6 months of surgery,the VAS score of the observation group was lower than that of the control group,while the FMA score and Harris hip joint function score were higher than those of the control group,with statistically significant differences(all P＜0.001).At 6 months after surgery,the hip joint angles of external rotation,internal rotation,abduction,adduction,extension,and flexion in both groups were greater than those before surgery,and the observation group was greater than the control group,with statistically significant differences(all P＜0.05).The clinical efficacy excellent and good rate of the observation group was higher than that of the control group[97.2％(35/36)vs 80.6％(29/36)],and the difference was statistically significant(x2=5.063,P=0.024).There was no statistically significant difference in the total incidence of complications between the observation group and the control group(P＞0.05).Conclusions The combination of improved core decompression and bone grafting surgery combined with porous tantalum rod material for the treatment of early ONFH is feasible.The method is safe and easy to operate,and can effectively alleviate hip and knee pain in early ONFH patients,and improve hip joint mobility and balance ability.