Abstract
Introduction
What is the most effective treatment of the early stages for osteonecrosis of the femoral head? Since the results of several treatment modalities such as multiple drilling, core decompression with or without bone graft, and vascularized fibular grafts have not been completely successful, we tried multiple drilling and stem cell transplantation to treat the early stages of osteonecrosis of the femoral head and to minimize patient morbidity. We report the clinical and radiological results of stem cell transplantation and core decompression.
Methods
One hundred and twenty-eight patients (190 hips) who had undergone surgery were divided in two groups based upon which treatment they had received: (1) multiple drilling and stem cell transplantation, and (2) core decompression, curettage, and bone graft. The clinical and radiological results of the two groups were compared. We defined failure as the need for additional surgery, or a Harris hip score of less than 75 points.
Results
After a minimum 5-year follow-up in the stem cell transplantation group, 64.3% (27/42) of hips with Stage IIa disease, 56.7% (21/37) of hips with Stage IIb disease, and 46.9% (23/49) of hips with Stage III disease had no additional surgery. In the conventional core decompression group, 66.7% (6/9) of hips with Stage IIa disease, 66.7% (6/9) of hips with Stage IIb disease, and 60% (3/5) of hips with Stage III disease had no additional surgery. Survival rates of patients with Ficat Stages I or II lesions were greater than survival rates for patients with Stage III lesions. There was no difference of survival rate between the two groups.
Conclusion
When comparing the clinical and radiological results of the two methods, we found that there was no significant difference between the two groups. The same results were found between stem cell transplantation and the conventional method of core decompression.
