Ischemic necrosis of the femoral head is a common disease in daily orthopedic clinics, and the current treatment means include surgery and conservative treatment. Our department adopts minimally invasive hip release therapy to treat osteonecrosis of the femoral head with good results.
General information
Thirty patients were selected from July 2011 to April 2014, who were outpatients and inpatients in our department, with clinical symptoms of hip pain, different degrees of dysfunction, some with reflex pain or involvement pain of thigh and knee joints. Patients diagnosed with stage I-II and pre-IQ femoral head necrosis and patients with late stage IQ and stage W who did not want surgery but strongly requested conservative treatment.
Treatment method
The patient is positioned on the healthy side, and the center is the greater trochanter of the femur on the affected side, above which 7 to 8 points are fan-shaped under the iliac spine about 4 to 150 px from the greater trochanter, with a distance of about 75 px between the points. 60° oblique slowly advance layer by layer.
When there was a sense of breakthrough under the needle knife and a sense of negative pressure was felt when the needle knife was withdrawn, the hip joint cavity was reached, and the joint capsule was loosened by deep and shallow three-dimensional cutting and inserting, and withdrawn when the sense of negative pressure under the needle knife was reduced. The above-mentioned hip decompression and soft tissue release therapy around the hip joint were performed once or twice a week depending on the patient’s tolerance level, and a course of treatment was conducted in one month. the efficacy was counted after 3 months.
Ischemic necrosis of the femoral head is a common disease in daily orthopedic clinics, and the current treatment includes surgical treatment and conservative treatment. Our department adopts minimally invasive hip release therapy to treat osteonecrosis of the femoral head with good results.
General information
Thirty patients were selected from July 2011 to April 2014, who were outpatients and inpatients in our department, with clinical symptoms of hip pain, different degrees of dysfunction, some with reflex pain or involvement pain of thigh and knee joints. Patients diagnosed with stage I-II and pre-IQ femoral head necrosis and patients with late stage IQ and stage W who did not want surgery but strongly requested conservative treatment.
Treatment method
The patient is positioned on the healthy side, and the center is the greater trochanter of the femur on the affected side, above which 7 to 8 points are fan-shaped under the iliac spine about 4 to 150 px from the greater trochanter, with a distance of about 75 px between the points. 60° oblique slowly advance layer by layer.
When there was a sense of breakthrough under the needle knife and a sense of negative pressure was felt when the needle knife was withdrawn, the hip joint cavity was reached, and the joint capsule was loosened by deep and shallow three-dimensional cutting and inserting, and withdrawn when the sense of negative pressure under the needle knife was reduced. The above hip joint cavity decompression and soft tissue release therapy around the hip joint were treated once or twice a week according to the patient’s tolerance level, and one course of treatment was conducted in one month.
Efficacy statistics
After the treatment, 24 patients had no obvious pain or little pain in the hip joint, and the mobility of the hip joint improved, especially the internal rotation of the joint was obvious, which could meet the basic needs of daily life. The total effective rate of treatment reached 80.0%.
Patients often have pathological changes such as hypercoagulable state of the body’s blood, abnormal hemodynamics, lipid metabolism disorder and vascular damage, which in turn lead to obstruction of venous return in the blood circulation of the femoral head, thus leading to abnormal increase of intraosseous pressure in the femoral head and intra-articular cavity pressure. Ultimately, this can lead to insufficient perfusion of arteries and obstruction of venous return, resulting in a state of ischemia and hypoxia in bone cells.
The combined application of acupuncture hip decompression and soft tissue release around the medullary joint can significantly reduce intracapsular pressure, which can help restore arterial blood flow to the femoral head and thus improve local ischemia and hypoxia, while smooth venous return can help metabolic transfer of inflammatory mediators and reduce the stimulation of sensory nerve endings by inflammation, thus reducing pain.
The professor even pointed out that: needle knife is the product of the combination of Chinese and Western medicine, which has the effect of acupuncture in Chinese medicine, which can unblock the meridians and regulate the qi and blood functions of the internal organs, but also has the efficacy of Western medicine percutaneous minimally invasive surgical treatment, through the release of the hip joint cavity by needle knife, the joint capsule can be cut open, so that the abnormally elevated pressure inside the capsule can leak into the surrounding tissue gap through the orifice of needle knife, playing a similar role of drainage and decompression.
The use of needle knife to release the soft tissues around the medullary joint can play a role in releasing or relieving the tension, contracture and adhesion of soft tissues, thus correcting the imbalance of the mechanical balance of the medullary joint, so that the pressure within the joint capsule and the femoral head can be reduced to a certain extent.
After the treatment, 24 patients had no obvious pain or little pain in the hip joint, and the mobility of the hip joint improved, especially the internal rotation of the joint was obvious to meet the basic needs of daily life. The total effective rate of treatment reached 80.0%
Patients often have pathological changes such as hypercoagulable state of the body’s blood, abnormal hemodynamics, lipid metabolism disorder and vascular damage, which in turn lead to obstruction of venous return in the blood circulation of the femoral head, thus leading to abnormal increase of intraosseous pressure in the femoral head and intra-articular cavity pressure. Ultimately, this can lead to insufficient perfusion of arteries and obstruction of venous return, resulting in a state of ischemia and hypoxia in bone cells.
The combined application of acupuncture hip decompression and soft tissue release around the medullary joint can significantly reduce intracapsular pressure, which can help restore arterial blood flow to the femoral head and thus improve local ischemia and hypoxia, while smooth venous return can help metabolic transfer of inflammatory mediators and reduce the stimulation of sensory nerve endings by inflammation, thus reducing pain.
The professor even pointed out that: needle knife is the product of the combination of Chinese and Western medicine, which has the effect of acupuncture in Chinese medicine, which can unblock the meridians and regulate the qi and blood functions of the internal organs, but also has the efficacy of Western medicine percutaneous minimally invasive surgical treatment, through the release of the hip joint cavity by needle knife, the joint capsule can be cut open, so that the abnormally elevated pressure inside the capsule can leak into the surrounding tissue gap through the orifice of needle knife, playing a similar role of drainage and decompression.
The use of needle knife to release the soft tissues around the medullary joint can play a role in releasing or relieving the tension, contracture and adhesions of the soft tissues, thus correcting the imbalance of the mechanical balance of the medullary joint, so that the pressure within the joint capsule and the femoral head can be reduced to a certain extent.