[Clinical analysis of light bulb operation with nano-hydroxyapatite/collagen for the treatment of osteonecrosis of the femoral head]

Abstract

Objective: To retrospectively analyze the clinical effect of light bulb operation with nano-hydroxyapatite/ collagen in a consecutive series of patients with osteonecrosis of the femoral head (ONFH).

Methods: From January 2001 to July 2005, 26 patients (35 hips) were treated, 16 males and 10 females, aged 19-54 years old (33.5 on average). The course of disease was 12-36 months (18 months on average). Based on the etiology, 15 cases (22 hips) were steroid induced type, 10 (12 hips) were alcohol induced type and the other one (1 hip) was idiopathic type. According to the system of Association Research Circulation Osseous (ARCO), there were 6 hips of stage IIB, 16 hips of stage IIC, 9 hips of stage IIIA, 3 hips of stage IIIB and 1 hip of stage IIIC. The Harris score was 62.2 +/- 7.5. All the patients who had undergone light bulb operation with nano-hydroxyapatite/collagen were evaluated both clinically and radiographically. The bone graft mixture rate of nano-hydroxyapatite/collagen and autogenous bone was 1 : 1, and the mixed bone graft was 6 times of the scraped osteonecrosis volume (30-48 mL).

Results: The incisions of all 26 patients (35 hips) obtained healing by first intention. The 2 cases, which got lateral femoral cutaneous nerve injury during the operation, recovered 3-6 months after the operation without any treatment. Another 2 cases got heterotopic ossification 3 months after operation, with no special treatment. All the 26 patients (35 hips) were followed up for 2-7 years (3.5 on average). The patients' bone healing began from the 3rd month after operation. The postoperative Harris score was 85.1 +/- 16.2, and there was significant difference compared with the preoperative one (P < 0.001). There were 15 hips of excellent, 11 of good, 5 of fair, and 4 of poor which received total hip arthroplasty at the end of the follow-up. According to imaging, 5 hips were progressed from preoperative IIC to IIIA, while the other hips were radiologically stable, with no progress of ONFH.

Conclusion: Light bulb operation with nano-hydroxyapatite/collagen provides a surgical treatment to treat early ONFH with satisfactory clinical outcomes. Nano-hydroxyapatite/collagen is beneficial for the repair and reconstruction of ONFH and suitable for femoral-head-preserving operation for the patients with ONFH of stage II.