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Erschienen in: International Orthopaedics 1/2021

27.11.2020 | Original Paper

Endoscopic observation finding in the core decompression procedure of osteonecrosis of femoral head and effect of additional treatments

verfasst von: Hyon Pak, Song Gun Ri, Myong Guk Jang, Sung Jae Kim

Erschienen in: International Orthopaedics | Ausgabe 1/2021

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Abstract

Purpose

To observe necrotic findings of the femoral head through the endoscopic examination when performing the decompression procedure widely used in the treatment of osteonecrosis of femoral head. To assess the efficacy of injection of bone marrow aspirated from the iliac crest and new vascularized bone graft into the core of femoral head based on the endoscopic findings.

Methods

The first stage of osteonecrosis of femoral head based on ARCO classification includes 23, second stage 36, and third stage eight femoral heads. Bone marrow transplantations have been performed in 49 hip joints and new vascularized bone grafts in 18 hip joints.

Results

The endoscopic findings of osteonecrosis of femoral heads are varied, and they can be divided into five categories. The average time in core decompression and bone marrow injection was 15 minutes, and the average time of new pedicled bone grafts was 65 minutes (45–90 minutes). The efficacy of bone marrow injection was 93.88%, and the efficacy of vascularized bone graft was 94.44% when performed based on the endoscopic findings.

Conclusion

It is possible to increase the treatment efficacy of the osteonecrosis of the femoral head when appropriate additional treatments are applied based on endoscopic findings in the decompression procedures of pre-collapse osteonecrosis of the femoral head.
Literatur
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Zurück zum Zitat Cao H et al (2016) Review of various treatment options and potential therapies for osteonecrosis of the femoral head. J Orthopaed Trans 4:57–70CrossRef Cao H et al (2016) Review of various treatment options and potential therapies for osteonecrosis of the femoral head. J Orthopaed Trans 4:57–70CrossRef
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Zurück zum Zitat Zhao DW et al (2012) Combined vascularized iliac and greater trochanter graftings for reconstruction of the osteonecrosis femoral head with collapse: reports of three cases with 20 years follow-up. Microsurgery 32:546–551CrossRef Zhao DW et al (2012) Combined vascularized iliac and greater trochanter graftings for reconstruction of the osteonecrosis femoral head with collapse: reports of three cases with 20 years follow-up. Microsurgery 32:546–551CrossRef
Metadaten
Titel
Endoscopic observation finding in the core decompression procedure of osteonecrosis of femoral head and effect of additional treatments
verfasst von
Hyon Pak
Song Gun Ri
Myong Guk Jang
Sung Jae Kim
Publikationsdatum
27.11.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 1/2021
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04863-9

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