Platelet-Rich Plasma-Incorporated Autologous Granular Bone Grafts Improve Outcomes of Post-Traumatic Osteonecrosis of the Femoral Head |
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| Institution: | 1. Department of Orthopaedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;2. Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;1. Department of Orthopaedic Surgery, Putrajaya Hospital, Putrajaya, Malaysia;2. Department of Orthopedic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, South Korea;3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea;4. Department of Orthopaedic Surgery, Seoul Hospital, Seongnam-si, South Korea;5. Department of Orthopaedic Surgery and Traumatology, Sarawak General Hospital, Kuching, Malaysia;1. Orthopedic Research Institute, Holy Cross Hospital, Ft. Lauderdale, FL;2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA;3. Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY;4. Department of Orthopaedic Surgery, Cleveland Clinic Hospital, Cleveland, OH;5. Department of Orthopaedic Surgery, University of Miami Hospital, Miami, FL;1. Department of Orthopaedic Surgery, Westchester Medical Center, Valhalla, NY;2. Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, CA;3. Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC;4. Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA;1. Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan;2. Department of Clinical Biomechanics, School of Medicine, Keio University, Tokyo, Japan |
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| Abstract: | BackgroundTo investigate the effects of platelet-rich plasma (PRP)-incorporated autologous granular bone grafts for treatment in the precollapse stages (Association of Research Circulation Osseous stage II–III) of posttraumatic osteonecrosis of the femoral head.MethodsA total of 46 patients were eligible and enrolled in the study. Twenty-four patients were treated with core decompression and PRP-incorporated autologous granular bone grafting (treatment group), and 22 patients were treated with core decompression and autologous granular bone grafting (control group). During a minimum follow-up duration of 36 months, X-ray and computed tomography were used to evaluate the radiological results, and the Harris hip score (HHS) and visual analog scale were chosen to assess the clinical results.ResultsBoth the treatment and control groups had a significantly improved HHS (P < .001). The minimum clinically important difference for the HHS was reached in 91.7% of the treatment group and 68.2% of the control group (P < .05). The HHS and visual analog scale in the treatment group were significantly improved than that in the control group at the last follow-up (P < .05). Successful clinical and radiological results were achieved 87.5% and 79.2% in the treatment group compared with 59.1% and 50.0% in the control group (P < .05), respectively. The survival rates based on the requirement for further hip surgery as an endpoint were higher in the treatment group in comparison to those in the control group (P < .05).ConclusionPRP-incorporated autologous granular bone grafting is a safe and effective procedure for treatment in the precollapse stages (Association of Research Circulation Osseous stage II–III) of posttraumatic osteonecrosis of the femoral head. |
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| Keywords: | platelet-rich plasma autogenous bone graft core decompression post-traumatic osteonecrosis of the femoral head clinical results |
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