Aseptic necrosis of the femoral head (ANFH) has a high incidence in the community and causes substantial problems with health as well as economic and social stress. Core decompression is the most commonly used treatment for early ANFH. Although many studies have reported on the efficacy of femoral head core decompression surgery for ANFH, there are still some shortcomings in assessing the severity of femoral head necrosis, the location distribution, and changes in necrotic lesions before and after surgery. Magnetic resonance imaging (MRI) and equivalent sphere model analysis were used to further clarify the clinical efficacy of percutaneous multiple small-diameter drilling core decompression in patients with ANFH. From July 2013 to November 2016, 24 patients (32 cases of the hip joint) with ANFH who underwent percutaneous multiple small-diameter drilling core decompression were selected, and a retrospective analysis was conducted. MRI as well as VAS, OHS-C, and HHS scores were used to evaluate joint function in all patients before and 6, 12, and 24 months after the operation. Twenty-four months after the operation, 10 hips were amputated. The survival rates of alcoholic femoral head necrosis (AFNH), idiopathic femoral head necrosis (IFHN), and steroid-induced femoral head necrosis (SIFHN) patients at 24 months were 100%, 85.7% (− 2 hips), and 0.0% (− 8 hips), respectively. The MRI and equivalent sphere analysis results revealed that the anterior superior medial quadrant was the area most prone to osteonecrosis, and the posterior superior medial quadrant was the area second most prone to necrosis. After the operation, the average percentage of the AFHN necrosis area in the total volume of the femoral head decreased from 14.5 to 10.3%, and the average percentage of the IFHN necrosis area decreased from 16.3 to 9.2%; however, the average percentage of the necrosis area for SIFHN increased from 30.4 to 33.1%. Percutaneous multiple small-diameter drilling core decompression significantly reduced the lesion volume for AFHN and IFHN, but the effect on SIFHN was not good.

中文翻译：

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经皮多直径小直径钻芯减压治疗无菌性股骨头坏死患者的预后研究：一项基于磁共振成像和等效球体模型分析的回顾性队列研究。

股骨头无菌性坏死（ANFH）在社区中发病率很高，并导致健康以及经济和社会压力方面的重大问题。核心减压是早期ANFH的最常用治疗方法。尽管许多研究报道了股骨头核心减压术对ANFH的疗效，但在评估股骨头坏死的严重程度，位置分布以及手术前后坏死病变的变化方面仍然存在一些缺陷。磁共振成像（MRI）和等效球体模型分析用于进一步阐明ANFH患者经皮多次小直径钻芯减压的临床疗效。从2013年7月到2016年11月，选择经皮多发小径钻芯减压术治疗的24例ANFH患者（髋关节32例），并进行回顾性分析。MRI以及VAS，OHS-C和HHS评分均用于评估术前，术后6、12、24个月的所有患者的关节功能。手术后二十四个月，截肢10髋。酒精性股骨头坏死（AFNH），特发性股骨头坏死（IFHN）和类固醇诱发的股骨头坏死（SIFHN）患者在24个月时的生存率为100％，85.7％（− 2髋）和0.0％（ − 8髋）。MRI和等效球体分析结果表明，前上内侧象限是最容易发生骨坏死的区域，后内侧上象限是最容易坏死的区域。手术后，股骨头总体积中AFHN坏死面积的平均百分比从14.5％下降到10.3％，IFHN坏死面积的平均百分比从16.3％下降到9.2％；但是，SIFHN的坏死面积平均百分比从30.4％增加到33.1％。经皮多次小直径钻芯减压显着减少了AFHN和IFHN的病变体积，但对SIFHN的效果不佳。SIFHN的坏死面积平均百分比从30.4％增加到33.1％。经皮多次小直径钻芯减压显着减少了AFHN和IFHN的病变体积，但对SIFHN的效果不佳。SIFHN的坏死面积平均百分比从30.4％增加到33.1％。经皮多次小直径钻芯减压显着减少了AFHN和IFHN的病变体积，但对SIFHN的效果不佳。