Erschienen in:
01.05.2008 | Symposium: Molecular and Surgical Advances in Osteonecrosis
Vascularized Fibular Grafting for Osteonecrosis of the Femoral Head With Unusual Indications
verfasst von:
J. Mack Aldridge III, MD, James R. Urbaniak, MD
Erschienen in:
Clinical Orthopaedics and Related Research®
|
Ausgabe 5/2008
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Abstract
We retrospectively reviewed the charts of 154 patients of various subgroups treated with the free vascularized fibular graft procedure for osteonecrosis of the femoral head (ONFH), evaluating pre- and postoperative Harris hip scores, hip range of motion, radiographs, and number of conversions to total hip arthroplasty (THA). Patients were followed a minimum of 1 year (mean, 6.8 years, range, 1 to 19 years). Athletes and patients with pyarthrosis-related osteonecrosis had high Harris hip scores at final review with scores of 94 and 97, respectively. Patients with ONFH after a slipped capital femoral epiphysis or following pregnancy had a low conversion rate to THA at 6% and 8%, respectively. Twenty-five percent of patients with transplant-related osteonecrosis of the femoral head were converted to THA at an average of 2.7 years. However, with select subsets of patients (athletes, pregnancy, organ transplant, femoral neck non-union, slipped capital femoral epiphysis, infection) the FVFG can result in a high rate of success.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.