[Conservative methods for osteonecrosis of the femoral head: the review of 1005 cases].
ABSTRACT To research on the conservative methods used to preserve the femoral head of patients with osteonecrosis of the femoral head.
In these series surgical procedures the osteonecrotic lesion was removed and various vascularized bone blocks or periosteal flaps with its nutrient vessels were transferred to regain sphericity of the femoral head and reinforce the sequestrum. The current study assessed 1005 patients (1226 hips) operated on from 1989 to 2002 with an average follow-up of 5.1 years (range, 1.5-15 years). The mean age of the patients was 37.4 years (range, 17-65 years).
Sixty-one hips (57 patients) had conversion surgery to a total hip arthroplasty because of progressive collapse or severe pain, or both. In the patients without failure, postoperative Harris hip score improved significantly. Of the 1174 reconstructions that were in situ, 1041 (89.4%) were clinically successful, and 878 (75.4%) were radiologically successful. In relation to the stage of necrosis according to the classification system of Ficat and Alert, good results were achieved in 95.3% of the patients with stages II disease, 87.9% with stages III and 60.8% with stages IV.
Conservative methods of vascularized bone block or periosteal flap transfer should be considered in active symptomatic patients to preserve the femoral head. In addition, the earlier the stages of the disease the better outcome could be obtained.
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ABSTRACT: The matching quality between the femoral head prosthesis and the acetabulum plays an important role in the operative treatment of femoral head prosthetics and femoral head replacement. To obtain the optimal model of the femoral head prosthesis for the target sufferer, an individualized modeling system is shown in this paper. It can recover the necrotic femoral heads into the satisfactory models. These models can well match with the acetabulum. This new system affords a theoretical model for the accurate operation position fixing in the orthopedic clinic. And this system also provides an innovative practical means for the individualized modeling of the artificial femoral head prosthesis. Copyright © 2012 John Wiley & Sons, Ltd.03/2013; 29(3):380-91. DOI:10.1002/cnm.2512
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ABSTRACT: The matching quality between the femoral head prosthesis and the acetabulum plays an important role in the operative treatment of the artificial femoral head replacement. In order to obtain a more accurate model of the femoral head prosthesis for the target sufferer, an improved individualized modeling system was presented in this paper. It was different from our previous system based on the sphere fitting method. This new system could reconstruct a more accurate ellipsoid model of the femoral head for the target sufferer. It could recover the necrotic femoral heads into the satisfactory models. These models could well match with the acetabulums. This improved system afforded a theoretical model for the accurate surgical position fixing in the orthopaedic clinic. And this system also provided an innovative practical means for the individualized modeling and manufacture of the artificial femoral head prosthesis.The Visual Computer 12/2013; 29(12). DOI:10.1007/s00371-012-0767-z · 1.07 Impact Factor