FEMORAL HEAD DECOMPRESSION AND GRAFT: TECHNIQUE WITH NEW INSTRUMENTS

ABSTRACT Introduction: Osteonecrosis of the femoral head (ONFH) is a pathology that can be treated with many approaches by the hip surgeon. Advanced decompression is a technique that aims to prevent the collapse of the femoral head and the arthrosis process of the joint, a technique already widespread and used by hip surgeons. In this study, we performed the technique with a new retractable blade and a new bone substitute as graft for the femoral head. Objective: To evaluate the technique with new instruments (EasyCore Hip®) and a calcium phosphate bone substitute (Graftys® HBS). Methods: Patients with osteonecrosis of the femoral head without major degenerative changes, such as femoral head collapse, were selected. Femoral head decompression was performed using the EasyCore Hip® retractable blade along with the calcium phosphate bone substitute as graft (Graftys® HBS). Results: The instruments proved to be reliable and reproducible, and the bone substitute presented good mechanical resistance, maintaining its temperature during the surgery. The disposable retractable blade presents variation in size and angle, which is an advantage in the removal of necrotic bone. However, we must take some precautions in order to achieve a better result. Conclusion: using EasyCore Hip® instruments and a calcium phosphate bone substitute (Graftys® HBS) is safe; however, some precautions must be taken during the use of the technique. Level of Evidence IV, Case Series.摘要 引言：股骨头缺血性坏死（Osteonecrosis of the femoral head, ONFH）是一种可由髋关节外科医生通过多种术式治疗的病理病症。先进减压术是一种旨在防止股骨头塌陷及关节退行性病变进程的技术，目前已被髋关节外科医生广泛推广并应用。本研究采用新型可伸缩刀片及新型骨替代材料作为股骨头移植物开展该术式。 目的：评估采用新型器械（EasyCore Hip®）与磷酸钙骨替代材料（Graftys® HBS）的该术式效果。 方法：选取未出现股骨头塌陷等重大退行性改变的股骨头缺血性坏死患者。采用EasyCore Hip®可伸缩刀片实施股骨头减压术，并以磷酸钙骨替代材料（Graftys® HBS）作为移植物。 结果：该器械被证实可靠且可重复，骨替代材料具备良好的机械强度，术中可维持温度稳定。一次性可伸缩刀片具备尺寸与角度的可调性，这为坏死骨的清除带来了优势。但为获得更佳疗效，仍需采取部分预防措施。 结论：使用EasyCore Hip®器械与磷酸钙骨替代材料（Graftys® HBS）的术式安全可靠，但在操作过程中需采取部分注意事项。 证据等级：IV级，病例系列研究。