Comparison of clinical efficacy between SHD-IBG and PVIBGT in the treatment of ARCO stage Ⅲ ONFH combined with DCE-MRI technology
Objective:Combined with DCE-MRI technology,to compare SHD-IBG with PVIBGT in the treatment of ARCO stage Ⅲ ONFH.Methods:30 patients with ARCO stage III ONFH admitted to Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2012 to July 2022 were selected and divided into group A(SHD-IBG)and group B(PVIBGT)according to different treatment methods.Based on Harris score and imaging data,the long-term efficacy of the two groups was compared and analyzed,and DCE-MRI technology was used to analyze the changes in microcirculation in the femoral head of the two groups 2 years after surgery.Results:Two years after surgery,the hip preservation rate was 93.3%in group A and 86.7%in group B.The average Harris score in both groups increased significantly 1 year after surgery compared to before surgery.The average Harris score in group A was 69.5 points before surgery,81.5 points 1 year after surgery,and 73.6 points 2 years after surgery.The average Harris score in group B was 70.7 points before surgery,78.9 points 1 year after surgery,and 72.5 points 2 years after surgery.There was a statistically significant difference(P<0.05)in the average Harris scores between the two groups of patients at 1 and 2 years after surgery.DCE-MRI analysis showed that,compared with preoperative results,the blood flow perfusion in the femoral head necrosis area increased in both groups 2 years after surgery,and the high perfusion in the repair reaction area improved.Conclusion:By combining DCE-MRI technology and comparing the long-term efficacy of SHD-IBG and PVIBGT in treating ARCO stage III ONFH,it is found that both surgical procedures can delay the progression of femoral head necrosis,and the clinical effect of SHD-IBG is better than PVIBGT.
Surgical dislocationPercutaneous bone graftingTransfer of vascularized iliac bone flapARCO stage Ⅲ femoral headrosisDynamic enhanced magnetic resonance imaging
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