Clinical efficacy of hip arthroscopy combined with multiple small-diameter drilling decompression in the treatment of early avascular necrosis of femoral head
- VernacularTitle:髋关节镜联合多次小直径钻孔减压治疗早期股骨头缺血性坏死的临床疗效
- Author:
Mingxing HU
1
;
Peng XING
1
;
Dacheng LI
1
;
Yang LI
1
Author Information
- Publication Type:Journal Article
- Keywords: early avascular necrosis of femoral head; hip arthroscopy; drilling decompression; hip joint function; muscle strength
- From: China Journal of Endoscopy 2025;31(11):11-19
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the clinical efficacy of hip arthroscopy combined with multiple small-diameter drilling decompression in the treatment of early avascular necrosis of femoral head.Methods The study selected 150 patients with early avascular necrosis of femoral head who received treatment in our hospital from December 2019 to June 2023.According to the treatment method,they were divided into the individual drilling group(75 cases)and the multiple small-diameter drilling group(75 cases),with 4 cases in the individual drilling group and 2 cases in the multiple small-diameter drilling group.Finally,they were included in the individual drilling group(71 cases)and the multiple small-diameter drilling group(73 cases).The individual drilling group received hip arthroscopy combined with single drilling decompression,while the multiple small-diameter drilling group received hip arthroscopy combined with multiple small-diameter drilling decompression.Both groups were followed up for 1 year after surgery.The surgical related indicators,including hip joint function,pain degree(before surgery,3 months after surgery,and 1 year after surgery),muscle strength,quality of life(before surgery and 1 year after surgery),and bone metabolism indicators(before surgery and 3 months after surgery)between the two groups were compared.Results Compared with the individual drilling group,the intraoperative bleeding in the multiple small-diameter drilling group was less,the difference was statistically significant(P<0.05).1 year after surgery,the Harris scores of both groups were higher than those before surgery and 3 months after surgery.At 3 months after surgery,the Harris scores of both groups were higher than those before surgery,and 1 year after surgery,the Harris score of multiple small-diameter drilling group was higher than that of individual drilling group,and the differences were statistically significant(P<0.05).1 year after surgery,the visual analogue scale(VAS)scores of the two groups were lower than those before surgery and 3 months after surgery,and lower than those before surgery at 3 months after surgery.Moreover,at 3 months and 1 year after surgery,VAS scores of the multiple small-diameter drilling group were significantly lower than those of the individual drilling group,and the differences were statistically significant(P<0.05).Compared with before surgery,1 year after surgery,the proportion of patients with muscle strength level 4 and scores of 36-Item Short Form Health Survey in both groups increased,and compared with the individual drilling group,those in the multiple small-diameter drilling group were higher,the differences were statistically significant(P<0.05).Compared with before surgery,at 3 months after surgery,the levels of serum bone morphogenetic protein 2(BMP-2),25-hydroxycholecalciferol,and insulin-like growth factor-1(IGF-1)in both groups increased,and compared with the individual drilling group,the multiple small-diameter drilling group was higher,the difference was statistically significant(P<0.05);The levels of serum C-telopeptide of type II collagen(CTX-II)in both groups decreased,and compared with the individual drilling group,that in the multiple small-diameter drilling group was lower,the differences were statistically significant(P<0.05).Conclusion The use of hip arthroscopy combined with multiple small-diameter drilling decompression for the treatment of early avascular necrosis of femoral head results in relatively less intraoperative bleeding,the degree of postoperative pain is mild,and the improvement effects of bone metabolism indicators and muscle strength are superior to those of decompression by individual drilling alone.It can significantly improve the hip joint function and quality of life of patients.It is a worthy clinical application.
