■股骨头缺血性坏死在常规骨科临床中很常见。挑战出现在没有明显放射学证据的情况下管理早期阶段(I和II)。作者通过比较早期AVN患者的外科手术程序来探索这一幼稚的研究领域。
■从2020年11月至2023年2月对82例接受手术减压和佐剂治疗的患者进行了一项前瞻性多中心研究,关于定义的纳入和排除标准。评估了射线不透性和骨内水肿的消退率以及THA转化率。髋关节疼痛VAS,腹股沟/大腿疼痛,盘腿坐的困难发生率,无痛的步行距离,哈里斯髋关节得分,30-s椅子测试,并注意到并发症。
■在82名患者中,平均年龄为28.46岁.男性:女性的比例为3.9:1。8.5%有双边情感,48.78%有阳性家族史。93.90%表现为腹股沟疼痛和盘腿坐位困难,限制了85.3%的髋关节运动,大腿疼痛占54.87%。Harris髋部在第3组中得分最差,其次是第2组和第1组。63.41%和36.58%的患者有1级和2级AVN,分别。术后1周,96.3%和93.9%的患者腹股沟和大腿疼痛缓解,分别(p<0.001);趋势为第3组>第2组>第1组。髋关节疼痛VAS遵循类似的趋势。4周时,第3组>第2组>第1组Harris髋关节评分改善。6个月时,趋势是第2组>第3组>第1组.第3组的30位椅子测试结果更好,无痛的步行距离,盘腿坐的时间更长。并发症发生率为3.6%。6.09%的患者术后行THA。第3组早期硬化斑块和骨髓水肿消退,即分别为46天和31天,其次是第2组和第1组。
■在第一阶段和第二阶段AVN中,双平面核心减压(双)和骨内注射PRP是一个有希望的挽救选择;患者有更好的早期髋关节评分(4周),和早期腹股沟和大腿疼痛恢复。早期治疗的患者具有更好的临床和放射学恢复。
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UNASSIGNED: Avascular necrosis of the femoral head is common in routine orthopedic clinics. The challenge arises in managing early stages (I and II) without obvious radiological evidence. Authors explore this naïve research area by comparing surgical procedures in early AVN patients.
UNASSIGNED: A prospective multicentric study was performed from November 2020 to February 2023 on 82 patients treated with surgical
decompression and adjuvants, concerning the defined inclusion and exclusion criteria. Radiopacity and intraosseous edema resolution and THA conversion rates were assessed. Hip pain VAS, groin/thigh pain, difficulty in sitting cross-legged incidence, pain-free walking distance, Harris hip scores, 30-s chair test, and complications were noted.
UNASSIGNED: Among 82 patients, the mean age was 28.46 years. Male:female ratio of 3.9:1. 8.5% had bilateral affection and 48.78% had a positive family history. 93.90% presented with groin pain and difficulty in sitting cross-legged, restricted hip movements in 85.3%, and thigh pain in 54.87%. Harris hip scored worst in Group 3 followed by Group 2 and Group 1. 63.41% and 36.58% of patients had Grades 1 and 2 AVN, respectively. At 1 week post-operatively, 96.3% and 93.9% of patients were relieved from groin and thigh pain, respectively (p < 0.001); the trend being Group 3 > Group 2 > Group 1. Hip pain VAS followed a similar trend. At 4 weeks, Harris hip scores improved in Group 3 > Group 2 > Group 1. At 6 months, the trend was Group 2 > Group 3 > Group 1. Group 3 had better 30-s chair test results, pain-free walking distance, and longer cross-legged sitting time. Complication rate of 3.6%. 6.09% of patients underwent THA later. Sclerotic patch and marrow edema resolution early in Group 3, i.e., 46 and 31 days respectively, followed by Group 2 and Group 1.
UNASSIGNED: In Stages I and II AVN, biplanar core
decompression (double) and intraosseous PRP injection is a promising salvage option; patients have better early hip scores (4 weeks), and early groin and thigh pain recovery. Patients treated early have better clinical and radiological recovery.
UNASSIGNED: