The results of core decompression treatment in patients with avascular necrosis of femoral head in patients at Isfahan City educational hospitals in 2010-2011

Authors
Mohammadreza Etemadifar 1
Mehdi Kooskzari 2
Nazem Khalilollah 3
Mehrabi Kooshki Ali 3
Behnamoon Mahsa 4
1 Associate Professor, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Orthopedics Resident, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Master’s, Epidemiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Cardiovascular Diseases Resident, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background : Avascular necrosis (AVN) of femoral head is one of the multifactorial pathologies, which can disturb hip joint and its range of motion. There have been several therapeutic methods for this pathology, but the results are controversial. Some studies show that core compression prevents the progress of the disease and its symptoms. This study aims to explore this issue.
Materials and Methods : This clinical trial was conducted on patients who were diagnosed with AVN of femoral head stage I, II A, at educational hospitals of Isfahan in 2010. The patients who met the inclusion criteria and suffered from AVN of femoral head stage I, II A for any reason (primary or secondary), entered the study. Six and 12 months after surgery, final assessment in terms of range of motion, return to work, and severity of pain based on vancouver associated score (VAS) was made and recorded. The duration of hospitalization and rate of infection were also recorded. The data were entered into and analyzed by the SPSS software.
Results: Mean and standard deviation of pain severity before surgery was 6.82 ± 1.74 in the participants. After 6 months, pain severity reduced to 4.05 ± 1.29, and after 12 months, it reached 2.41 ± 1.82. On the basis of analysis of variance with repeated observation, the severity of pain was significantly reduced in 1 year (P<0.001).
Conclusion: It can be concluded that core decompression in patients with AVN of femoral head stage I, II A can improve pain in hip area and increase range of motion.

Keywords

1. Garino JP, Steinberg MA. Total hip arthroplasty in patients with avascular necrosis of femoral head. A 2 to 10 years follow up. Clin Orthop Relat Res 1997;334:108-15.  Back to cited text no. 1
    
2. Koo SH, Song HR, Yang JW, Yang P, Kim JR, Kim YM. Trochanteric rotational osteotomy for osteonecrosis of femoral head. J Bone Joint Surg 2001;83B:83-9.  Back to cited text no. 2
    
3. Learmonth ID, Maloon S, Dall G. Core decompression for early atraumatic osteonecrosis of femoral head. J Bone Joint Surg 1990;72B:78-90.  Back to cited text no. 3
    
4. Steinberg ME, Larcon PG, Strafford B, Hosick WB, Corces A, Bands RE, et al. Core decompression with bone grafting for osteonecrosis of femoral head. Clin Orthop Relat Res 2001;386:71-8.  Back to cited text no. 4
    
5. Gangji V, Hauseur JP, Matos C, De Maertelaer V, Toungouz M, Lambermont M. Treatment of osteonecrosis of femoral head with implantation of autologous bone-marrow cells. J Bone Joint Surg 2004;86-A:1153-60.  Back to cited text no. 5
    
6. Aigner N, Schneider W, Eberl V, Knahr K. Core decompression in early stages of femoral head osteonecrosis-an MRI-controlled study. Int Orthop. 2002;26:31-5.  Back to cited text no. 6
    
7. Chen CH, Chang JK, Huang KY, Hung SH, Lin GT, Lin SY. Core decompression for osteonecrosis of the femoral head at pre-collapse stage. Kaohsiung J Med Sci 2000;16:76-82.  Back to cited text no. 7
    
8. Mont MA, Ragland PS, Etienne G. Core decompression of the femoral head for osteonecrosis using percutaneous multiple small-diameter drilling. Clin Orthop Relat Res 2004;429:131-8.  Back to cited text no. 8
    
9. Bellot F, Havet E, Gabrion A, Meunier W, Mertl P, de Lestang M. Core decompression of the femoral head for avascular necrosis [in French]. Rev Chir Orthop Reparatrice Appar Mot 2005;91:114-23.  Back to cited text no. 9
    
10. Li H, Zhang C. [Progress of joint-preserving procedures for treatment of avascular necrosis of femoral head] Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2006;20:655-8.  Back to cited text no. 10
    
11. Castro FP Jr, Barrack RL. Core decompression and conservative treatment for avascular necrosis of the femoral head: A meta-analysis. Am J Orthop (Belle Mead NJ) 2000;29:187-94.  Back to cited text no. 11
    
12. Steinberg ME. Core decompression of the femoral head for avascular necrosis: indications and results. Can J Surg 1995;38 (Suppl 1):S18-24.  Back to cited text no. 12
[PUBMED]   
Advanced Biomedical Research
Volume 2014, March
March 2014
Pages 1-5