2023, Vol. 27 ›› Issue (4): 547-551

Robot-assisted core decompression and bone grafting for ARCO II osteonecrosis of the femoral head

Li Hui1, 2, Zhang Kun2, Hao Yangquan2, Feng Lei2, Yang Zhi2, Xu Peng2, Lu Chao2   

Abstract: BACKGROUND: Core decompression and bone grafting is one of the main hip preservation methods for ARCO II osteonecrosis of the femoral head, but the traditional surgical methods have disadvantages such as long fluoroscopy time and large amount of blood loss.  
OBJECTIVE: To analyze the clinical characteristics of robot-assisted core decompression and bone grafting for the treatment of ARCO II osteonecrosis of the femoral head, and to provide new ideas for hip preservation treatment of osteonecrosis of the femoral head.
METHODS: A retrospective analysis was performed in 100 patients who underwent core decompression and bone grafting for osteonecrosis of the femoral head in the Department of Osteonecrosis and Joint Reconstruction, Honghui Hospital, Xi’an Jiaotong University from June 2017 to December 2019. Among them, 50 patients (36 males and 14 females) underwent core decompression and bone grafting assisted by orthopaedic robot navigation. The age ranged from 30 to 74 (47.52±12.50) years old and they were set as the robot navigation group. A total of 50 patients, including 37 males and 13 females, aged from 28 to 77 (50.68±13.60) years, who underwent core decompression and bone grafting, were enrolled as the conventional operation group. All operations were performed by the same surgeon. The preoperative, last follow-up Harris score, postoperative visual analog scale score, femoral head collapse, intraoperative fluoroscopy times, intraoperative blood loss and operation time were recorded in the two groups.  
RESULTS AND CONCLUSION: (1) All patients were followed up for 20-38 (28.53±0.50) months. (2) The total number of intraoperative X-ray fluoroscopy, the number of guide wire placement fluoroscopy, the number of bone graft fluoroscopy, the determination time of bone graft channel, and the operation time were (13.84±1.52) times, (5.64±1.14) times, (8.20±1.70) times, (20.39±1.46) minutes, and (39.37±1.96) minutes, respectively in the robot navigation group, and (18.94±1.32) times, (8.64±1.27) times, (10.30±1.79) times, (41.57±1.63) minutes, and (62.53±3.44) minutes, respectively in the conventional operation group (all P < 0.05). (3) There were no significant differences in the last Harris score, postoperative visual analog scale score, collapse of femoral head and intraoperative blood loss between the two groups (P > 0.05). (4) It is concluded that core decompression and bone grafting assisted by orthopaedic robot navigation for the treatment of ARCO II osteonecrosis of the femoral head can significantly improve the accuracy of the operation, reduce the intraoperative fluoroscopy times, shorten the operation time, and reduce the incidence of postoperative complications.
Key words: osteonecrosis of the femoral head, robot assisted navigation, core decompression and bone grafting, fluoroscopy times, femoral head collapse