Free Vascularized Fibular Grafting for the Treatment of Postcollapse Osteonecrosis of the Femoral Head

Berend, Keith R.; Gunneson, Eunice E.; Urbaniak, James R.

doi:10.2106/00004623-200306000-00001

Cited by 150 publications

(85 citation statements)

References 11 publications

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“…FVFG has reported rates of overall survivorship in the range of 61-96% [2][3][4][15][16][17]. In another study recently performed at our institution looking at 65 hips undergoing FVFG for multiple etiologies contributing to osteonecrosis of the femoral head, 40% of patients went on to THA at an average of 8.3 years after undergoing FVFG [4].…”

Section: Resultsmentioning

confidence: 99%

Vascularized Fibular Grafts for Avascular Necrosis After Slipped Capital Femoral Epiphysis: Is Hip Preservation Possible?

Bertrand

Urbaniak

Lark

2013

Clinical Orthopaedics &Amp; Related Research

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Background Avascular necrosis (AVN) of the femoral head is a potential complication in patients with slipped capital femoral epiphysis (SCFE), radiographically occurring in 3-60%. This may lead to early hip fusion or hip arthroplasty. Free vascularized fibular grafting (FVFG) may provide a reasonable means to preserve the femoral head. Questions/Purposes We asked: (1) What percentage of patients with AVN after SCFE treated with FVFG underwent subsequent THA or hip fusion and what was the lifespan of the FVFG? (2) Did the graft survival rate of FVFG for AVN after SCFE coincide with historically reported rates of FVFG for idiopathic AVN? And (3) did hip function improve after FVFG? Methods We retrospectively reviewed 52 patients who underwent FVFG for SCFE. We calculated the longevity of the graft and factors associated with graft survival. Harris hip scores (HHS) were recorded pre-and postoperatively. Minimum followup was 1 month (median, 19 months; range, 1-136 months).

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Section: Resultsmentioning

confidence: 99%

Vascularized Fibular Grafts for Avascular Necrosis After Slipped Capital Femoral Epiphysis: Is Hip Preservation Possible?

Bertrand

Urbaniak

Lark

2013

Clinical Orthopaedics &Amp; Related Research

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“…The advantage of FVFG lies in the combination of femoral head decompression, removal of necrotic lesion, introduction of osteoinductive cancellous bone, and vascularised cortical bone support of the subchondral surface [24]. There are multiple reports on the successful mid-and long-term outcomes of FVFG [7][8][9]. Zhang et al [8] used FVFG to treat 56 hips in 48 patients, with mean follow-up of 16 months.…”

Section: Discussionmentioning

confidence: 99%

“…Free vascularised fibular grafting (FVFG) has been successfully used as a joint preserving procedure for treatment of ONFH, and many reports demonstrate satisfying mid-and long-term outcome on general patients [7][8][9]. However, reports of FVFG for treatment of ONFH in lymphoma patients are rare.…”

Section: Introductionmentioning

confidence: 99%

Treatment of osteonecrosis of the femoral head in lymphoma patients by free vascularised fibular grafting

Yin

Zhang

Jin

et al. 2010

International Orthopaedics (SICOT)

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The purpose of this study was to assess the outcomes of treatment of femoral head osteonecrosis using free vascularised fibular grafting in patients with Hodgkin's disease and non-Hodgkin's lymphoma. We retrospectively reviewed seven patients (14 hips) with lymphoma who underwent free vascularised fibular grafting for osteonecrosis of the femoral head, evaluating pre-and postoperative Harris hip scores, visual analog scale (VAS) pain scores, hip range of motion and radiographs. Patients were followed up for a minimum of 1.5 years (mean, 3.3 years). All these patients exhibited good recovery without severe lifethreatening complications. The mean Harris hip score improved from 69 to 88, while average VAS pain score decreased from 54 to 18. At the latest follow-up, we found improvement or unchanged radiographs in all three hips with initial Steinberg stage II osteonecrosis and in nine of 11 hips with stage III or IV osteonecrosis. No hips failed treatment and underwent total hip arthroplasty. The clinical data demonstrated that free vascularised fibular grafting can slow or even halt progression of necrosis, and improve the function of the hip and quality of life in lymphoma patients.

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“…Non-vascularised bone grafting from different sources have been used to fill the necrotic area in the femoral head and provide structural support to the subchondral bone and articular cartilage, thereby preventing collapse during mechanism repair [14,15]. Vascularized bone grafting include the fibula [16] and iliac crest bone block transfer [17][18][19][20]. Currently, there is no consensus regarding the treatment of the different stages of ONFH to reliably prevent ONFH progression.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic changes in osteonecrosis treatment of the femoral head with iliac bone flaps pedicled with the lateral femoral circumflex artery ascending branch: A 10-year report

Liu

Zhao

Wang

et al. 2016

THC

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Free Vascularized Fibular Grafting for the Treatment of Postcollapse Osteonecrosis of the Femoral Head

Cited by 150 publications

References 11 publications

Vascularized Fibular Grafts for Avascular Necrosis After Slipped Capital Femoral Epiphysis: Is Hip Preservation Possible?

Vascularized Fibular Grafts for Avascular Necrosis After Slipped Capital Femoral Epiphysis: Is Hip Preservation Possible?

Treatment of osteonecrosis of the femoral head in lymphoma patients by free vascularised fibular grafting

Hemodynamic changes in osteonecrosis treatment of the femoral head with iliac bone flaps pedicled with the lateral femoral circumflex artery ascending branch: A 10-year report

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