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タイトル: | Percutaneous autologous impaction bone graft for advanced femoral head osteonecrosis: a retrospective observational study of unsatisfactory short-term outcomes |
著者: | Kuroda, Yutaka https://orcid.org/0000-0003-0746-0280 (unconfirmed) Nankaku, Manabu Okuzu, Yaichiro Kawai, Toshiyuki Goto, Koji Matsuda, Shuichi |
著者名の別形: | 黒田, 隆 南角, 学 奥津, 弥一郎 河井, 利之 後藤, 公志 松田, 秀一 |
キーワード: | Osteonecrosis Femoral head Avascular necrosis Joint-preserving surgery Bone graft Core decompression Total hip arthroplasty Collapse Survivorship Regenerative therapy |
発行日: | Dec-2021 |
出版者: | Springer Nature BMC |
誌名: | Journal of Orthopaedic Surgery and Research |
巻: | 16 |
論文番号: | 141 |
抄録: | BACKGROUND: Half of osteonecrosis of the femoral head (ONFH) patients suffer femoral head collapse at initial diagnosis, and more than half are bilaterally affected. This study developed a percutaneous autologous impaction bone graft (IBG) technique as a modification of core decompression (CD). We also summarized the short-term results and treatment efficacy of percutaneous autologous IBG in advanced ONFH. METHODS: Twenty patients (12 males, 8 females) with nontraumatic, postcollapse ONFH except one case underwent CD (10-mm core diameter) and reverse IBG. Radiological changes of the ONFH stage and type were analyzed. Survival analysis using Kaplan-Meier estimates was performed with conversion to total hip arthroplasty (THA) as the endpoint. In addition, the Harris hip score (HHS) and University of California, Los Angeles (UCLA) activity rating scale were evaluated. RESULTS: Percutaneous autologous IBG was performed successfully, with an average operation time of < 1 h and small blood loss, and 7 patients (35%) needed conversion to THA at an average of 17 months postoperatively. We observed radiological progressive change in 60% of the patients during a mean observation period of 3 years. The mean clinical scores, except data recorded, after THA significantly improved (before vs. after 3 years: UCLA activity score, 3.7 vs. 5.2 [P = 0.014]; HHS, 57.6 vs. 76.5 points [P = 0.005]). In addition, 6 patients showed radiological progression but no clinical deterioration. CONCLUSIONS: Percutaneous autologous IBG was technically simple and minimally invasive, but short-term results were unsatisfactory for advanced ONFH. Indications for this procedure should be carefully examined to improve it in order to enable bone formation. |
著作権等: | © The Author(s). 2021 This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. |
URI: | http://hdl.handle.net/2433/287445 |
DOI(出版社版): | 10.1186/s13018-021-02288-7 |
PubMed ID: | 33596957 |
出現コレクション: | 学術雑誌掲載論文等 |
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