Affiliated Hospital of Taishan Medical University Taian ChinaShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
刊名
Journal of Orthopaedic Surgery & Research
年份
2018
卷号
Vol.13
页码
1
ISSN
1749-799X
摘要
Background: Nontraumatic osteonecrosis of the femoral head is treated with a series of methods. High-energy extracorporeal shock wave therapy is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. Methods: Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I–III nontraumatic ONFH, according to the Association...更多
Background: Nontraumatic osteonecrosis of the femoral head is treated with a series of methods. High-energy extracorporeal shock wave therapy is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. Methods: Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I–III nontraumatic ONFH, according to the Association Research Circulation Osseous system, were reviewed in the current retrospective study. The visual analog pain scale , Harris hip score, radiography, and magnetic resonance imaging were used to estimate treatment results. The progression of ONFH was evaluated by imaging examination and clinical outcomes. The results were classified as clinical success and imaging success . Results: The mean follow-up duration was 130.6 months . The mean VAS decreased from 3.8 before ESWT to 2.2 points at the 10-year follow-up . The mean Harris hip score improved from 77.4 before ESWT to 86.9 points at the 10-year follow-up. The clinical success rates were 87.5% in ARCO stage I patients, 71.4% in ARCO stage II patients, and 75.0% in ARCO stage III patients. Imaging success was observed in all stage I hips, 64.3% of stage II hips, and 12.5% of stage III hips. Seventeen hips showed progression of the ARCO stage/substage on imaging examination. Eight hips showed femoral head collapse at the 10-year follow-up. Four hips in ARCO stage III and one hip in ARCO stage II were treated with total hip arthroplasty during the follow-up. Three were performed 1 year after ESWT, one at 2 years, and one at 5 years. Conclusions: The results of the current study indicated that ESWT is an effective treatment method for nontraumatic ONFH, resulting in pain relief and function restoration, especially for patients with ARCO stage I–II ONFH.收起
