To Evaluate the Effectiveness of the Proposed Method of Surgical Treatment of Patients With Early Stages of Aseptic Necrosis of the Femoral Head From the Standpoint of Evidence-Based Medicine

Abstract

Femoral head cancer is of great socio-economic importance in all countries of the world: for example, in the United States, up to 18 percent of all total arthroplasty (TETS) operations are performed for this pathology annually, and in Asian regions the situation is even more serious - in Taiwan, Korea, Hong Kong, and Japan. There are more than forty TETS operations due to AVN. Aseptic necrosis of the femoral head (ANGBC) is a disabling clinical disease characterized by the death of osteocytes and bone marrow, followed by resorption of necrotized tissues, which leads to progressive destruction of bone architecture, subchondral fracture and collapse of the femoral head, and, finally, loss of congruence in the joint with loss of its basic functions. Without treatment, more than 70% of femoral heads in osteonecrosis (OH) are destroyed within 3-4 years after diagnosis according to X-ray diagnostics, and therefore endoprosthesis surgery is required, which is also painful for many patients due to severe joint pain. In addition, according to a number of authors, asymptomatic avascular necrosis (AVN) can develop up to 5 years in 94% of patients, the manifestation of clinical symptoms in such patients already corresponds to a high stage of the disease. There is no up-to-date epidemiological data on ANGBC in Russia. It is known that IT affects men more often in middle age, and women more often after the age of 50, and at the age of 20-40, men are about 7-8 times more likely than women to get sick; necrotic changes in more than half of those affected affect both TBS. The problem of developing new treatment methods for ANGBI is especially relevant for young patients who lead an active lifestyle. Without timely and effective treatment, coxarthrosis often progresses, leading to unbearable pain and immobility. Thus, early intervention, taking into account the stage and mechanism of pathology development, is key to the success of organ-sparing procedures for non-surgical treatment of ANGBI. It is especially important to create comprehensive treatment methods, including drugs and methods that affect all parts of the pathological process, relieve pain, stimulate regenerative processes in the head of the TBS and, accordingly, avoid or delay the operation of endoprosthetics.