BIORESORBABLE MATERIALS FOR BONE DEFECTS SUBSTITUTION IN PATIENTS WITH OSTEONECROSIS OF THE FEMORAL HEAD

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Abstract

Osteonecrosis of the femoral head is one of the serious diseases of the hip. The outcome of the disease is the development of osteoarthritis of the hip in patients of working age. Today, one of the most popular surgical procedures in the early stages of the disease remains a core decompression. The purpose of the study was to understand the efficacy and safety of core decompression and filling bone defect bioresorbable materials. Material and methods. From 2006 to 2014 in Vreden Russian Research Institute for Traumotology and Orthopedics 62 patients (79 hips) with different stages of osteonecrosis of the femoral head were treated. In all patients the classical decompression chamber of femoral head osteonecrosis was performed. In 36 patients (48 hips) the decompression was done with no additional processing the chamber, in 25 patients (31 joints) after decompression the treatment of osteonecrosis zone to the healthy bone was performed. In 56 cases the bioresorbable granular material based on calcium sulfate was used for filling the defect, in 6 cases - β-3 calcium phosphate, in 17 cases - the bioresorbable material based on the combination of calcium sulfate and 3 ß-calcium phosphate. Results. In the mean follow-up of 26.9 (6 to 62) months, the overall survival rate was 54.4%. In patients with the second stage of the disease the arthroplasty was performed only in 17.6% of cases, while in patients with the fourth stage - in 100%. In the third stage of osteonecrosis a strong correlation of survival with the necrosis volume was observed. Conclusion. The success of surgical interventions directly depended on the stage of the process, volume and fullness of osteonecrosis zone, as well as on the type of bioresorbable material and fullness of bone defect filling.

About the authors

V. A. Konev

Vreden Russian Research Institute for Traumotology and Orthopedics

Author for correspondence.
Email: vladimirkonev24@mail.ru
Russian Federation

R. M. Tikhilov

Vreden Russian Research Institute for Traumotology and Orthopedics; Mechnikov NorthWestern State Medical University

Email: info@rniito.org
Russian Federation

I. I. Shubnyakov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: shubnyakov@mail.ru
Russian Federation

A. A. Myasoedov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: myasoedov_alexei@mail.ru
Russian Federation

A. O. Denisov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: med-03@yandex.ru
Russian Federation

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