Inverted femoral head graft versus standard core decompression in nontraumatic hip osteonecrosis at minimum 3 years follow-up

Purpose Numerous salvage surgeries were popularised to halt the progression of hip osteonecrosis (ON). We aimed to compare the clinico-radiological outcomes of inverted femoral head graft (IFHG) versus standard core decompression (SCD) in treatment of nontraumatic hip ON at pre-arthritic stage. Methods A case review was performed at a minimum 3 years follow-up of 61 patients (71 hips; mean age 32.96 (19-50) years; mean follow-up 7.86 (3-14) years; mean body mass index 28.58 (19-46); 32 males, 29 females) suffering nontraumatic hip ON at pre-arthritic stage. 38 hips underwent SCD and 33 IFHG. The outcome was assessed by changes in modified Harris Hip Score (MHHS), need for revision surgery and progression of modified Ficat-Arlet staging. Data were analysed including logistic regression and Kaplan-Meier survivorship analysis. Results 13/34 (38.2%) hips in SCD group were revised at 4.61 ± 2.61 years, while 7/33 (21.2%) in IFHG group at 8.43 ± 4.32 years (p = 0.023). MHHS was significantly higher in IFHG group at 1 and 3 years as well as at last follow-up (p = 0.014, 0.001 and 0.023 respectively). Clinical and radiological significant differences were found in survivorship analysis between both groups, in favor of IFHG. A higher clinical failure was noted among obese patients. Conclusions An IFHG technique offers a better alternative regarding postoperative clinico-radiological outcomes in nontraumatic hip ON at the pre-arthritic stage. A cautious prognosis is recommended in obese patients

The impact of intrinsic charm on the parton distribution functions

In this work, we present a new investigation about the impact of intrinsic charm (IC) on the physical observables, in particular, on the heavy structure function $F_2^c$. Since IC distribution is dominant at large Bjorken variable $x$, normally, it is expected that it can be explored only at large $x$. But, by studying the correlation of the charm density in the proton with $F_2^c$, we are going to show that the IC component can also be effective at low $x$. To investigate further, we perform three QCD global analyses of parton distribution functions (PDFs), by including the EMC $F_2^c$ data that are recognized as clear evidence for existence of the intrinsic charm in the proton, and also by considering the IC component. Although the fit of the EMC data is extremely poor due to the data points with lower $x$ values, i.e. $x<$0.05, but these analyses can give us new information about the impact of EMC data and IC contribution on the behaviour of PDFs.Comment: I withdraw this paper since my supervisor require me to withdraw this pape