Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study

Objective: This study aims to evaluate and compare the clinical and radiological results of the multiple drilling (MD) technique with the Modified Light Bulb (MLB) method for treating pre-collapse stage osteonecrosis of the femoral head (ONFH). Methods: This retrospective cohort study included thirt...

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Main Authors: Ali Parsa, Hamid Dolatabadi, Saeid Esmaeilian, Seyed Ali Moshtaghioon, Neda Mirzaei, Omid Shahpari, Elham Rahmanipour, Mohammad Ghorbani
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Orthopaedic Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X2400198X
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author Ali Parsa
Hamid Dolatabadi
Saeid Esmaeilian
Seyed Ali Moshtaghioon
Neda Mirzaei
Omid Shahpari
Elham Rahmanipour
Mohammad Ghorbani
author_facet Ali Parsa
Hamid Dolatabadi
Saeid Esmaeilian
Seyed Ali Moshtaghioon
Neda Mirzaei
Omid Shahpari
Elham Rahmanipour
Mohammad Ghorbani
author_sort Ali Parsa
collection DOAJ
description Objective: This study aims to evaluate and compare the clinical and radiological results of the multiple drilling (MD) technique with the Modified Light Bulb (MLB) method for treating pre-collapse stage osteonecrosis of the femoral head (ONFH). Methods: This retrospective cohort study included thirty-eight patients (51 hips) with non-traumatic ONFH treated with either the MD technique (23 hips) or the MLB method (28 hips) from March 2019 to March 2021. Evaluations of the patients were performed using the Visual Analog Scale (VAS), Harris Hip Score (HHS), Hip Dysfunction and Osteoarthritis Outcome Score (HOOS), and Ficat-Arlet classification at the initial, six-month, and twelve-month postoperative intervals. Results: Significant improvements in VAS, HHS, and HOOS scores were observed in both groups from baseline to the 12-month follow-up (p < 0.001). At the six-month mark, the MLB group exhibited significantly lower VAS scores (3.82 ± 2.43 vs. 5.30 ± 2.54, p = 0.03) and at twelve months (3.07 ± 2.81 vs. 5.17 ± 3.14, p = 0.01). Additionally, HOOS scores were significantly higher in the MLB group at six months (59.99 ± 18.88 vs. 49.16 ± 17.20, p = 0.03) and twelve months (65.88 ± 19.72 vs. 52.13 ± 23.73, p = 0.04) compared to the MD group. Although the clinical success rate was greater in the MLB group (57.1 % vs. 39.1 %), this difference was not statistically significant (p = 0.20). Preoperative ARCO stage was a significant predictor of clinical outcomes in both groups. Conclusions: Both MD and MLB techniques are effective for treating non-traumatic ONFH in the pre-collapse stage, with the MLB technique showing superior outcomes in terms of pain relief and functional improvement. Early diagnosis and intervention are crucial for achieving optimal results.
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spelling doaj-art-b9873bec8e4b4c96ba4aa40c72c6b8442025-08-20T02:39:28ZengElsevierJournal of Orthopaedic Reports2773-157X2025-04-014110050310.1016/j.jorep.2024.100503Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort studyAli Parsa0Hamid Dolatabadi1Saeid Esmaeilian2Seyed Ali Moshtaghioon3Neda Mirzaei4Omid Shahpari5Elham Rahmanipour6Mohammad Ghorbani7American Hip Institute, Chicago, United States; Orthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran; Corresponding author. Orthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Radiology, Shiraz University of Medical Sciences, Zand Street, Shiraz, IranDepartment of Radiology, Shiraz University of Medical Sciences, Zand Street, Shiraz, IranDepartment of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranOrthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, IranOrthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, IranImmunology Research Center, Mashhad University of Medical Sciences, Mashhad, IranOrthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, IranObjective: This study aims to evaluate and compare the clinical and radiological results of the multiple drilling (MD) technique with the Modified Light Bulb (MLB) method for treating pre-collapse stage osteonecrosis of the femoral head (ONFH). Methods: This retrospective cohort study included thirty-eight patients (51 hips) with non-traumatic ONFH treated with either the MD technique (23 hips) or the MLB method (28 hips) from March 2019 to March 2021. Evaluations of the patients were performed using the Visual Analog Scale (VAS), Harris Hip Score (HHS), Hip Dysfunction and Osteoarthritis Outcome Score (HOOS), and Ficat-Arlet classification at the initial, six-month, and twelve-month postoperative intervals. Results: Significant improvements in VAS, HHS, and HOOS scores were observed in both groups from baseline to the 12-month follow-up (p < 0.001). At the six-month mark, the MLB group exhibited significantly lower VAS scores (3.82 ± 2.43 vs. 5.30 ± 2.54, p = 0.03) and at twelve months (3.07 ± 2.81 vs. 5.17 ± 3.14, p = 0.01). Additionally, HOOS scores were significantly higher in the MLB group at six months (59.99 ± 18.88 vs. 49.16 ± 17.20, p = 0.03) and twelve months (65.88 ± 19.72 vs. 52.13 ± 23.73, p = 0.04) compared to the MD group. Although the clinical success rate was greater in the MLB group (57.1 % vs. 39.1 %), this difference was not statistically significant (p = 0.20). Preoperative ARCO stage was a significant predictor of clinical outcomes in both groups. Conclusions: Both MD and MLB techniques are effective for treating non-traumatic ONFH in the pre-collapse stage, with the MLB technique showing superior outcomes in terms of pain relief and functional improvement. Early diagnosis and intervention are crucial for achieving optimal results.http://www.sciencedirect.com/science/article/pii/S2773157X2400198XFemur head necrosisLight bulbMultiple drillingOsteonecrosisArthroplasty
spellingShingle Ali Parsa
Hamid Dolatabadi
Saeid Esmaeilian
Seyed Ali Moshtaghioon
Neda Mirzaei
Omid Shahpari
Elham Rahmanipour
Mohammad Ghorbani
Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study
Journal of Orthopaedic Reports
Femur head necrosis
Light bulb
Multiple drilling
Osteonecrosis
Arthroplasty
title Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study
title_full Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study
title_fullStr Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study
title_full_unstemmed Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study
title_short Comparing modified light bulb with multiple drilling methods in treating non-traumatic femoral head osteonecrosis: A cohort study
title_sort comparing modified light bulb with multiple drilling methods in treating non traumatic femoral head osteonecrosis a cohort study
topic Femur head necrosis
Light bulb
Multiple drilling
Osteonecrosis
Arthroplasty
url http://www.sciencedirect.com/science/article/pii/S2773157X2400198X
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