Comparison of clinical effect between minimally invasive allo-fibula implantation with core decompression and bone grafting through fenestration over femoral head and neck in treatment of early femoral head necrosis

Objective To compare the clinical effect between minimally invasive allo-fibula implantation with core decompression and bone grafting through fenestration over femoral head and neck in the treatment of early femoral head necrosis. Methods From November 2009 to November 2013, 30 patients(40 hips) with early osteonecrosis of femoral head(stage Ⅱ B- Ⅲ A according to the classification system of ARCO) were selected in this study. Those patients were randomly assigned to group A and B, treated by minimally invasive allo-fibula implantation with core decompression(20 hips) and bone grafting through fenestration over femoral head and neck respectively(20 hips) respectively. The VAS score in 1 week after operation and Harris hip score(HHS) at last follow-up were compared between these two groups. Results The VAS score in1 week after operation: group A score was(2.40±1.20) and group B score(4.30±1.50), group A were lower than group B, the difference was significant(t =-3.81, P 0.05). All the 30 patients(40 hips) were followed up for 8-40 months, average 24 months. At the last follow up, the Harris hip aggregate score,pain score and range of motion score of patients in group A were all higher than that in group B, the difference was significant(P 0.05). The HHS of group A with stage ARCOⅡ B was higher than that in group B, the difference was significant(P 0.05); because of the small samples size, stage ARCOⅡ C and ARCOⅢ A had no statistical difference between group A and B(P 0.05). Conclusion Minimally invasive allo-fibula implantation with core decompression is an effective method for treatment of early femoral head necrosis, and it also can improve the prognosis of femoral head necrosis.