title: Core decompression in combination with nano-hydroxyapatite/polyamide 66 rod for the treatment of osteonecrosis of the femoral head.
abstract: BACKGROUND
  The aim of this study was to investigate the effectiveness of core decompression in combination with a nano-hydroxyapatite/polyamide 66 (n-HA/PA66) rod and a porous bioglass bone graft for the treatment of osteonecrosis of the femoral head (ONFH).
  
  
  METHODS
  Sixty-four patients (84 hips) with ONFH were allocated to a program of either core decompression (CD) in combination with a n-HA/PA66 rod and a porous bioglass bone graft (treatment group) or CD with an autologous cancellous bone graft (control group). Clinical and radiographic retrospective follow-ups were performed on all patients with the prospectively collected data.
  
  
  RESULTS
  The overall clinical failure rate in the treatment group (9/38, 23.68%) was lower than that of the control group (24/46, 52.17%) (p < 0.05). Harris hip scores (HHS) were significantly increased in both groups post-surgery (p < 0.05). There was a significant difference between the two groups on HHS improvement for Steinberg IIC and IIIA (p < 0.05 and p < 0.001, respectively). The visual analogue scale (VAS) was significantly decreased in both groups post-surgery (p < 0.05). Especially, significant difference in the VAS improvement was observed between the groups for IIB, IIC and IIIA (p < 0.05, p < 0.05 and p < 0.01, respectively).
  
  
  CONCLUSIONS
  Core decompression combined with the implantation of a n-HA/PA66 rod and a bioglass bone graft can significantly decrease hip pain, improve hip function, and prevent the collapse of the femoral head in patients with ONFH. As the effectiveness of this approach appears to vary with Steinberg stage, we suggest that this treatment procedure may be suitable for patients with early to middle stage ONFH.
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an, 710004, Shaanxi, People's Republic of China.
authors.forename: Pei
authors.initials: P
authors.lastname: Yang
authors.forename: Chuanbao
authors.initials: C
authors.lastname: Bian
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.forename: Anli
authors.initials: A
authors.lastname: Shi
authors.forename: Chunsheng
authors.initials: C
authors.lastname: Wang
authors.forename: Kunzheng
authors.initials: K
authors.lastname: Wang
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D001858:Bone Nails; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation; D002516:Ceramics / Q000627:therapeutic use; D019299:Decompression, Surgical; D017886:Durapatite / Q000627:therapeutic use; D005260:Female; D005271:Femur Head Necrosis / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D049329:Nanostructures / Q000627:therapeutic use; D009757:Nylons
chemical_list: D001672:Biocompatible Materials; C022107:Bioglass; D018786:Bone Substitutes; D009757:Nylons; D017886:Durapatite