Mid-term Clinical Outcomes of "Light Bulb" Core Decompression with Arthroscopic Assistance in Peri-collapse Osteonecrosis of the Femoral Head: A Retrospective Comparative Study

作者全名：Yang, Jibin; Sun, Pengpeng; Liu, Ziming; Li, Yuwan; Zhang, Jun; Liu, Yi; Zou, Gang

作者地址：[Yang, Jibin; Sun, Pengpeng; Liu, Ziming; Liu, Yi; Zou, Gang] Peking Univ, Peking Univ Hosp 3, Inst Sports Med, Dept Sports Med,Beijing Key Lab Sports Injuries, Beijing, Peoples R China; [Li, Yuwan; Zou, Gang] Zunyi Med Univ, Dept Orthoped Surg, Affiliated Hosp, 149 Dalian Rd, Zunyi 563003, Guizhou, Peoples R China; [Zhang, Jun] Chongqing Med Univ, Dept Orthoped, Affiliated Hosp 1, Orthoped Lab, Chongqing, Peoples R China

通信作者：Liu, ZM; Zou, G (通讯作者)，Peking Univ, Peking Univ Hosp 3, Inst Sports Med, Dept Sports Med,Beijing Key Lab Sports Injuries, Beijing, Peoples R China.; Zou, G (通讯作者)，Zunyi Med Univ, Dept Orthoped Surg, Affiliated Hosp, 149 Dalian Rd, Zunyi 563003, Guizhou, Peoples R China.

来源：ORTHOPAEDIC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001215190100001

JCR分区：Q2

影响因子：1.8

年份：2024

卷号：16

期号：6

开始页：1399

结束页：1406

文献类型：Article

关键词：Core decompression; Hip arthroscopy; Light bulb; Necrosis of the femoral head; Peri-collapse

摘要：Objective: Nontraumatic osteonecrosis of the femoral head (ONFH) is commonly encountered in orthopedics. Without early clinical intervention, most patients with peri-collapse of the ONFH will develop femoral head necrosis and eventually require hip replacement surgery. The aim of this study is to evaluate clinical outcomes in patients with ONFH who underwent "light bulb" core decompression (CD) with arthroscopic assistance and to compare them with the outcomes of those treated with traditional procedures. Methods: A retrospective review of patients with Stage II and IIIA (Peri-collapse) radiographic findings based on the Association Research Circulation Osseous (ARCO) stage for ONFH who underwent "light bulb" CD with or without arthroscopic assistance by a single-surgeon team between March 2014 and December 2018 was performed. All patients were followed up for a minimum of 2 years. The visual analogue scale (VAS) pain score, Harris hip score (HHS), and radiological imaging were evaluated. The categorical parameters were analyzed by chi-square test and the continuous variables conforming to a normal distribution were analyzed by Student's t-test. Results: The study included a total of 39 patients (18 and 21 patients in the with and without arthroscopic assistance groups, respectively), with a mean age of 40.3 years and a mean follow-up of 22.2 months. Overall, there was a better VAS score in the arthroscopic assistance group than in the control group (p < 0.05), There was a significant difference in HHS (80.1 +/- 9.2 vs 75.1 +/- 12.7) at the last follow-up (p < 0.05). The rate of good and excellent outcomes was 94%. Similarly, there was no significant difference in the total rate of complications or conversion to THA. Conclusion: With arthroscopic assistance, "light bulb" CD could be achieved via hip arthroscopy with less trauma, and it offered the opportunity for more precise evaluation and monitoring for therapy and yielded better VAS scores after surgery and better hip function outcomes at the last follow-up.

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