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Comparing Modified Light Bulb With Multiple Drilling Methods in Treating Non-Traumatic Femoral Head Osteonecrosis: A Cohort Study Publisher



Parsa A1, 2 ; Dolatabadi H3 ; Esmaeilian S3 ; Moshtaghioon SA4 ; Mirzaei N2 ; Shahpari O2 ; Rahmanipour E5 ; Ghorbani M2
Authors
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Authors Affiliations
  1. 1. American Hip Institute, Chicago, United States
  2. 2. Orthopedic Research Center, Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
  3. 3. Department of Radiology, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran
  4. 4. Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Source: Journal of Orthopaedic Reports Published:2025


Abstract

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. © 2024
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