[Drilling decompression for femoral head necrosis at collapse stage]

To explore clinical effects of drilling decompression for femoral head necrosis at collapse stage.

Totally 22 patients with femoral head necrosis on both side were analyzed from March 2006 to February 2009. Among them, there were 20 males and 2 females aged from 24 to 52 years old with an average of 38.4 years old. All patients were Ficat I on one side and Ficat I or II on another side. Drilling decompression were performed on all patients. The average followed-up period was 5.4 years (ranged, 1 to 8 years). The endpoint of severe pain(VAS ≥7), severe dysfunction (Harris ≤ 70), radiographic progression on Ficat IV and total hip arhtroplasty (THA) was used for survivorship analysis.

Severe pain as an endpoint,13 cases were survived on Ficat III and 18 cases on Ficat I or II (P>0.05). Severe dysfunction as an endpoint, 6 cases were survived on Ficat III and 18 on Ficat I or II (P<0.05). Radiographic progression on Ficat IV as an endpoint, 2 cases were survived on Ficat III and 18 on Ficat I or II (P<0.05). THA as an endpoint, 13 cases were survived on Ficat I and 18 cases on Ficat I or II (P>0.05).

Femoral head necrosis with Ficat III treated with drilling decompression could prolong progression of disease , decrease percentage of THA.