To analyze the effect and complications of superselective vascular intervention combined with core decompression bone grafting in patients with avascular necrosis of femoral head.

A prospective study of 92 patients with ischemic necrosis of the femoral head from January 2020 to January 2023 in the Second Hospital of Handan City was selected by simple random sampling, and the patients were divided into 46 cases in the study group and 46 cases in the control group by random number table method, in which 25 males and 21 females were in the study group, with ages ranging from 40 to 70 years, with a mean of (56.59±6.21) years, and 26 males and 20 females were in the control group, with ages ranging from 42 to 70 years, with a mean of (57.85±6.15) years. The control group was treated with core decompression and bone grafting, and the study group was treated with super-selective vascular intervention combined with core decompression and bone grafting. The results, Harris hip score, complications and quality of life (SF-36 scale) were compared2 years after surgery between the two groups.

The results of rank sum test for hierarchical data showed that the difference in surgical outcomes between the two groups was statistically significant (Z=12.699, P<0.05), and the excellent rate in the study group was higher than that in the control group (84.78% VS 50.00%) (χ²=12.662, P<0.05). The results of repeated measures ANOVA showed that at 2 years postoperatively, compared with the control group [(36.71±3.98) points, (34.28±4.54) points, (3.30±0.96) points, (3.33±0.90) points, and (77.63±8.75) points], the study group's functionality, pain, mobility, deformity, and Harris Hip Score [(40.74± 3.82), (38.46±3.86), (3.89±0.97), (3.89±0.97), (86.98±8.16)] were significantly higher in the study group (t=4.947, 4.746, 2.910, 2.901, 5.298, P<0.05). There was no statistically significant difference in the occurrence of postoperative complications and total complication rate (4.35% vs 13.04%) between the two groups (χ²=2.190, P>0.05). The SF-36 scale scores of each factor were higher in both groups at 2 years after surgery compared with the preoperative period (t=10.748/8.895, 9.078/6.221, 7.860/4.977, 6.165/4.224, 5.918/4.519, 11.746/10.577, and 5.820/3.773, P<0.05); and the study group had an increase in SF-36 scale scores at 2 years after surgery compared with the preoperative period. 2-year SF-36 scale scores for each factor [(61.09±7.26), (58.24±6.25), (68.06±7.21), (67.24±7.32), (64.17±8.21), (65.22±7.22), (65.13±6.14)] were higher than those of the control group [(55.45±7.12)points,, (65.13±6.14)]) points, (52.45±6.25) points, (61.25±6.21) points, (62.45±6.54) points, (60.12±7.22) points, (60.45±7.25) points, and (61.24±6.12) points] (t=3.762, 4.443, 4.854, 3.307, 2.515, 3.162, 3.043, P<0.05).

For patients with avascular necrosis of the femoral head, superselective vascular intervention combined with core decompression and bone grafting can achieve better results, improve hip function and quality of life.