Abstract

WU, Zhensong; SONG, Da; XU, Qi  and  WANG, Dawei. A comparative study on the clinical effectiveness of core decompression with bone grafting for treating alcohol-induced and traumatic osteonecrosis of the femoral head: a population-specific investigation in alcoholism. Invest. clín [online]. 2024, vol.65, n.3, pp.279-293.  Epub Sep 12, 2024. ISSN 0535-5133.  https://doi.org/10.54817/ic.v65n3a02.

Osteonecrosis of the femoral head (ONFH) is a debilitating orthopedic condition with two primary categories: traumatic osteonecrosis (TONFH) and non-traumatic ONFH, including alcoholic-induced osteonecrosis (AIONFH). Core decompression combined with bone grafting is a common treatment approach, but its efficacy and influencing factors in these two categories remain unclear. We conducted a study involving 50 patients (25 TONFH, 25 AIONFH) who underwent this procedure. Demographic data and clinical assessments were collected. The average age was 47.2 years, with 72% males. AIONFH patients had a higher BMI and more comorbidities like diabetes, hyperlipidemia, hypertension, and immune-related diseases. TONFH had a higher prevalence of osteoporosis and fracture history. Bilateral hip necrosis was more frequent in TONFH, while left hip necrosis dominated in AIONFH. Both groups mainly had JIC classifications C1 and C2. Preoperatively, most cases were ARCO grade III and IV, with lower Harris, PCS, and MCS scores. Both groups improved at the six-month post-operative assessment, with better results in AIONFH. The last follow-up was 16.62 months after treatment. In the final follow-up, AIONFH cases were mainly ARCO type I, and HHS, PCS, and MCS scores were significantly better than TONFH. Core decompression combined with bone grafting effectively treats AIONFH and TONFH, with superior outcomes in AIONFH. Factors influencing postoperative efficacy include BMI, JIC classification, and PCS score. These findings provide valuable insights for tailoring treatment strategies to specific ONFH categories.

Keywords : core decompression; bone grafting; traumatic osteonecrosis of the femoral head; alcoholic-induced osteonecrosis of the femoral head.

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