Rationale for minimally invasive surgery and its clinical use in early ANFH

Abstract

Objectives. A study of the expedience of arthroscopic revision of hip cavity in conjunction with tunnelling, revision and sanitation of the femoral head necrosis site, followed by bone alloplasty early in disease, during surgical treatment of ANFH patients.Materials and methods. Minimally invasive two-stage decompression with bone alloplasty was performed as a surgical treatment in stage 0, 1, 2 ANFH patients at the orthopaedic unit of Vladimirtsev Territorial Clinical Hospital of Khabarovsk during 2017–2021. The survey included 60 patients examined as follows: clinical examination, radiography, multislice computed tomography and magnetic resonance imaging, with follow-ups in 6 and 12 months.Results and discussion. A detailed arthroscopy analysis was performed at different stages of the disease sequence, which allowed a comprehensive comparison of X-ray and intraarticular change data.Conclusions. The study demonstrated that therapeutic and diagnostic hip arthroscopy offers a number of clear advantages and allows decision on a surgical treatment tactics that minimises postoperative complications. The use of minimally invasive surgeries in early ANFH allows a stable regain of the patient social activity to postpone radical surgical interventions.