The investigation on interventional therapy for avascular necrosis of femoral head

Objective To evaluate the effect and value of the interventional therapy for avascular necrosis of the femoral head(ANFH). Methods According to Hungerford staging of ANFH,48 patients with ANFH(68 hips) were analyzed by clinic and imageology.The interventional therapy was performed by superselective infusion of fibrinolysis and dilated medical treatment,and then catheter was inserted super selectively into medial femoral circumflex artery,and lateral femoral circumflex artery and lateral iliac artery.The results were evaluated before and after operation with hips function.Results 42 hips of 0-II stages were analyzed;there were significant difference between before operation and six months after operation.26 hips of III-Ⅳ stages were analyzed,there were not significant difference between before operation and six months.After interventional therapy,41(83%) patients showed significant changes of vessels in DSA on the affected side as compared with those before treatment;the lateral and medial circumflex femoral arteries showed an increase in the number and caliber of branches with marked extension of superior and inferior branches to the area of femoral head, pains and dysfunctions of 44(91%) patients' hip joints relieved or disappeared.X-ray,CT or MRI showed that the recovery of necrotic bone and formation of new bone in different degree was found.ConclusionsIliac external arteriae infusion of fibrinolysis and dilated medical treatment can efficiently increase caput femoris and physiological blood-supplied.Interventional therapy for ANFH I and II stages,the total arthroplasty can be avoided or delayed.