Platelet-Rich Plasma-Incorporated Autologous Granular Bone Grafts Improve Outcomes of Post-Traumatic Osteonecrosis of the Femoral Head

J Arthroplasty. 2020 Feb;35(2):325-330. doi: 10.1016/j.arth.2019.09.001. Epub 2019 Sep 9.

Abstract

Background: To 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.

Methods: A 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.

Results: Both 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).

Conclusion: PRP-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.

Keywords: autogenous bone graft; clinical results; core decompression; platelet-rich plasma; post-traumatic osteonecrosis of the femoral head.

MeSH terms

  • Bone Transplantation
  • Decompression, Surgical
  • Femur Head / diagnostic imaging
  • Femur Head / surgery
  • Femur Head Necrosis* / diagnostic imaging
  • Femur Head Necrosis* / etiology
  • Femur Head Necrosis* / surgery
  • Humans
  • Platelet-Rich Plasma*
  • Treatment Outcome