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| Clinical comparison of fibular graft with vascular pedicle and tantalum rod implantation in the treatment of early osteonecrosis of the femoral head |
| DENG Yingjie1 LONG Qiang2 FANG Rui1 |
1.The second Department of Orthopedics, Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China;
2.the Fourth Clinical Medical College of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China |
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Abstract Objective To compare the clinical efficacy of fibular graft with vascular pedicle (FVFG) and tantalum rod implantation (TRI) in the treatment of early osteonecrosis of the femoral head (ONFH). Methods Data of 23 cases (24 hips) of early ONFH treated with FVFG from January 2017 to July 2018 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University were collected (FVFG group), in addition, data of 22 patients (23 hips) receiving TRI surgery from January 2015 to December 2016 were collected (TRI group). Harris score of hip joint and X - ray performance index were compared 6 months after operation. Results In FVFG group, 2 patients were lost to follow-up because of losing contact. In the end, 21 patients were followed up for 6 to 18 months, with an average of （12.71±2.30）months. All patients in TRI group were followed up for 7 to 18 months, with an average of （13.31±1.33）months. The Harris score of hip joint of the two groups at 6 months after operation were higher than those before operation (P < 0.05)，and the Harris score of hip joint in FVFG group was higher than that in TRI group (P < 0.05). The excellent and good rate of Harris score of hip joint in TRI group was 54.55% (12/22), while that in FVFG group was 85.71% (18/21), and there was statistically significant difference in the excellent and good rate between the two groups （P ＜ 0.05）. The X-ray performance index of the two groups at 6 months after operation were higher than those before operation （P ＜ 0.05）, and the X-ray performance index of FVFG group at 6 months after operation was better than that of TRI group （P ＜ 0.05）. In FVFG group, 5 cases had imaging progress, 3 cases had total hip replacement, 11 cases had imaging progress in TRI group and 11 cases had total hip replacement. There was no statistically significant difference in the incidence of complications between the two groups （P ＞ 0.05）. Conclusion FVFG can improve hip function in early ONFH patients and is superior to TRI in preventing long-term femoral head collapse.
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