№ 3 / 2015 / 53-58

Estimation of efficiency of conservative treatment of aseptic necrosis of the femoral head

Author: Shusharin A.G.¹, Polovinka M.P.², Prokhorenko V.M.³

Abstract

The research objective. Comparison of the results and evaluation of the effectiveness of implemented into clinical practice methods of conservative treatment of patients with aseptic necrosis of the femoral head. Material and methods. The paper presents the results of conservative treatment of 328 patients with early stages of avascular necrosis underwent the courses of intra-articular injections of perftoran (group 1) or drug mixture perftoran – dimexide (group 2) under ultrasound guidance. Clinical and functional condition of the hip joint was evaluated on the Harris Hip Score at baseline and after 6, 12, 24, 36 months. Results and discussion. In group 1, after 36 months of starting treatment destructive processes in the joint were stopped in 91 (89.2 %) patients, aseptic necrosis in the reduction stage was revealed by MRI in 46 (45.1 %) patients; Harris hip score increased by an average of 38.8 points in patients with stage I disease. In the 2nd group of patients the significant reduction in pain as early as during the first course of treatment led to better dynamics by Harris scale. In periods of observation Harris hip score increased by an average of 46.5 and 46.7 points in patients with II and I stage of avascular necrosis, respectively. Thus, the pathogenesis based treatment of patients with early stage of avascular necrosis, aimed at addressing ischemia in the joint, improves functional status of patients, which is reflected in the reduction in the rate of destructive processes and maintaining the shape of the femoral head in most patients.

Key words

aseptic necrosis of the femoral head, intra-articular injections under ultrasound, conservative treatment, perftoran, dimexide, hip

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About Authors (Correspondence):

Shusharin A.G. – candidate of medical sciences, head of the laboratory of regenerative medicine, assistant professor, e-mail: shurin54@yandex.ru

Polovinka M.P. – candidate of chemical sciences, senior researcher of the laboratory of regenerative medicine, assistant professor, e-mail: marinapolovinka@yandex.ru

Prokhorenko V.M. – doctor of medical sciences, deputy director for research and clinical work, scientific director of the clinic of arthroplasty and endoscopic, professor, e-mail: vprohorenko@niito.ru

Full Text

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Received: 01/07/2015