| Objective To investigate whether core decompression (CD) surgery combined with platelet-rich plasma (PRP) and bone marrow mixture can improve clinical symptoms and radiological manifestations in patients with early avascular necrosis of the femoral head.Methods This retrospective study analysed 61 patients (61 hips) who were treated with CD at Xinjiang Uiger Municipal People's Hospital, with or without concurrent PRP treatment. Patients were categorized based on the surgical approach into group A (CD+bone graft+PRP) with 29 cases (29 hips, ARCO Ⅰ: 15 cases, ARCO Ⅱ: 8 cases, ARCO ⅢA: 6 cases) and group B (CD+bone graft) with 32 cases (32 hips, ARCO Ⅰ: 20 cases, ARCO Ⅱ: 7 cases, ARCO ⅢA: 5 cases). Postoperative recovery was assessed by comparing the visual analogue scale (VAS), Harris hip score (HHS), changes in the modified Kerboul angle, and radiological alterations between the two groups.Results During the one-year follow-up period, none of the patients in either group required hip replacement surgery and femoral head collapse was not observed in any of the imaging studies. The rates of positive X-ray changes were 34.5% in group A and 28.1% in group B, with no significant difference between the two groups (P>0.05). At the final follow-up, VAS scores for patients in both groups were significantly lower than pre-treatment levels. One month postoperatively, there was no significant difference in VAS scores between the two groups. However, six months after surgery, the VAS score in group A [(2.90±0.77) scores] was significantly lower than that in group B [(3.41±0.84) scores] (P<0.05). Similarly, the VAS score 12 months after the operation was significantly lower in group A [(2.93±0.84) scores] than that in group B [(3.50±1.05) scores] (P<0.05). The HSS scores of both groups increased significantly compared to pre-treatment levels. At both one and six months postoperatively, the HSS scores in group A were significantly higher than those in group B, specifically: 82.66±5.70 vs 76.13±4.35 at one month after surgery, and 84.28±5.62 vs 81.09±4.88 at six months after surgery. However, at 12 months after surgery, there was no significant difference in the HSS scores between the two groups (P>0.05). There was no statistically significant difference in the changes in the modified Kerboul angle between the two groups (group A: -6.14±13.23; group B: -1.28±12.35) (P>0.05). No severe postoperative complications were observed in any of the patients.Conclusion Compared to simple core decompression and bone grafting, core decompression and bone grafting combined with PRP treatment can significantly improve the function of the affected limb in the short term and provide sustained pain symptom relief. |
