Abstract:

ARCO stage Ⅲ avascular necrosis of femoral head (ANFH) is accompanied by collapse of the femoral head. For young patients with ANFH, it is still controversial to adopt hip replacement or hip-preserved surgery. Based upon our experience and previous experiments on the treatment of ANFH, the research group adopted minimally invasive hip preservation surgery. Before the operation, the detailed planning was made according to X-ray, CT images and 3D printing models. During the operation, core decompression was performed under C-arm fluoroscopy. The autologous intact bone-cartilage graft was obtained from the comparatively unimportant part of the femoral condyle, which was then transplanted to fill the collapsed area of the femoral head under C-arm. The iliac bone graft was resected to fill the tunnels in the femoral condyle and proximal femur. After the operation, the CT scan demonstrated that the intact bone-cartilage graft was flush with the surrounding femoral head, achieving the purpose of preoperative planning. This minimally invasive surgery provides a valuable and useful reference for young patients with ARCO stage Ⅲ ANFH.

Key words: Avascular necrosis of femoral head, Collapse, Minimally invasive hip-preserved surgery, Intact bone-cartilage graft