Free Vascularized Fibula Grafting for the Treatment of Osteonecrosis of the Femoral Head

Sotereanos, Dean G.; Plakseychuk, Anton; Rubash, Harry E.

doi:10.1097/00003086-199711000-00024

Cited by 83 publications

(44 citation statements)

References 17 publications

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“…6,7 Bone regeneration in the necrotic area is extremely slow after TRO and the progression of collapse of the necrotic area of the femoral head cannot be prevented entirely, regardless of its anterior transposition. Therefore, to prevent osteoarthritis due to progression of the necrotic process, it may be necessary to add a mechanical reconstruction such as a morsellised and impacted bone graft 20,21 or a free vascularised fibular graft 22,23 to this procedure.…”

Section: Discussionmentioning

confidence: 99%

A histological study of the necrotic area after transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head

Yasunaga

Hisatome

Ikuta

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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We studied nine patients who had had a transtrochanteric anterior rotational osteotomy, as developed by Sugioka, for osteonecrosis of the femoral head. At a mean of 2.5 years after the initial operation we carried out a histological study of the previously necrotic femoral head which had not shown collapse of the new primary weight-bearing site. In seven joints, there was proliferation of fibrous tissue in the dead trabeculae with vascular ingrowth. New bone covering dead trabeculae created the characteristic appearance of 'creeping substitution'. However, these changes were limited and did not extend over the entire necrotic area. Dead bone remained in all the cases. In the other two heads we did not observe proliferation of fibrous tissue or vascular ingrowth, only dead trabeculae and dead bone marrow.

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Section: Discussionmentioning

confidence: 99%

A histological study of the necrotic area after transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head

Yasunaga

Hisatome

Ikuta

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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“…Only 8 % of patients needed joint replacement in one study [48], and surgery was postponed by up to seven years in 70 % of patients in another report [9]. FVFGs have also been successful in treating teenagers with posttraumatic AVN [48,49], improving Harris hip scores (HHS) from 60.4 to 94.2, and appear to give more successful outcomes than other joint-preserving procedures [48][49][50]. Ultimately, the success of FVFGs depends on AVN aetiology, stage and size [13].…”

Section: Fvfg In Avascular Necrosismentioning

confidence: 99%

Free vascularised fibular grafts in orthopaedics

Bumbaširević

Stevanović

Bumbaširević

et al. 2014

International Orthopaedics (SICOT)

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Bony defects caused by trauma, tumors, infection or congenital anomalies can present a significant surgical challenge. Free vascularised fibular bone grafts (FVFGs) have proven to be extremely effective in managing larger defects (longer than 6 cm) where other conventional grafts have failed. FVFGs also have a role in the treatment of avascular necrosis (AVN) of the femoral head, failed spinal fusions and complex arthrodeses. Due to the fact that they have their own blood supply, FVFGs are effective even in cases where there is poor vascularity at the recipient site, such as in infection and following radiotherapy. This article discusses the versatility of the FVFG and its successful application to a variety of different pathologies. It also covers the applied anatomy, indications, operative techniques, complications and donor-site morbidity. Though technically challenging and demanding, the FVFG is an extremely useful salvage option and can facilitate limb reconstruction in the most complex of cases.

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“…Autologous bone grafts, such as the marrow graft, marrow aspirates, will contain cancellous and/or cortical or blocks such as vascularised Graft and will carry cells, matrix and potentially inductive molecules (Friedrich et al 2009;Sotereanos et al 1997). A vascularised graft will carry blood vessels to enrich the wound with nutrients and soluble mediators, which may support or inhibit bone formation and carry periosteum enriched with osteoprogenitor cells.…”

Section: Matrix-based Grafts Can Be Autologous Allogeneic or Biomatementioning

confidence: 99%

“…A vascularised graft will carry blood vessels to enrich the wound with nutrients and soluble mediators, which may support or inhibit bone formation and carry periosteum enriched with osteoprogenitor cells. There is less necrosis of grafted material during healing and vascularised grafts are thought to be a very reliable option for reconstructing non-union or osteonecrosis defects (Friedrich et al 2009;Gaskill et al 2009;Sotereanos et al 1997). The difficulty with all autogenous grafts is the quantity and morbidity, such as non-stress fracture for donor sites (Friedrich et al 2009).…”

Section: Matrix-based Grafts Can Be Autologous Allogeneic or Biomatementioning

confidence: 99%

Signals Between Cells and Matrix Mediate Bone Regeneration

Zohar¹

2012

Bone Regeneration

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Free Vascularized Fibula Grafting for the Treatment of Osteonecrosis of the Femoral Head

Cited by 83 publications

References 17 publications

A histological study of the necrotic area after transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head

A histological study of the necrotic area after transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head

Free vascularised fibular grafts in orthopaedics

Signals Between Cells and Matrix Mediate Bone Regeneration

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