Treatment of Osteonecrosis in the Hip of Pediatric Patients by Free Vascularized Fibular Graft

Dean, Gillian S.; Kime, Robert C.; Fitch, Robert D.; Gunneson, Eunice E.; Urbaniak, James R.

doi:10.1097/00003086-200105000-00014

Cited by 43 publications

(30 citation statements)

References 17 publications

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“…Although we do not have long-term outcomes ([ 10 years postoperatively) to report on, approximately 90% of patients undergoing FVFG for AVN after SCFE have retained their native hip at an average of 8.4 years. In other pediatric conditions, we have reported a survival rate approaching 85% at 4 years [3].…”

Section: Resultsmentioning

confidence: 84%

“…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%

“…1). While steroid-induced osteonecrosis has been the most prevalent indication for FVFG, data support its use in other pediatric conditions, such as trauma, pyarthrosis, and malignancy [3,15]. Overall, FVFG for AVN provides a near 75% rate of hip preservation for at least 10 years postoperatively (range, 10-26 years) [4].…”

Section: Introductionmentioning

confidence: 99%

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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: 84%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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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“…Despite including children who were younger than 7 years old [10,11,18,25,26] in five studies using four of the six PROs found (mHHS, HHS, Iowa, Merle d'Aubigné), the papers reviewed indicated no issues in the administration of these adult PROs (Table 2). Several papers directly compared results from a PRO administered to pediatric patients with results from adult studies using the same PRO [5,10,16,23,26]. It is clear that a hip-specific PRO validated for pediatric patients in a range of conditions, including impingement, is needed to fill a gap in the range of outcome measures available to clinicians and researchers.…”

Section: Discussionmentioning

confidence: 99%

What Clinimetric Evidence Exists for Using Hip-specific Patient-reported Outcome Measures in Pediatric Hip Impingement?

d’Entremont

Cooper

Johari³

et al. 2015

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].…”

Section: Discussionmentioning

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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Treatment of Osteonecrosis in the Hip of Pediatric Patients by Free Vascularized Fibular Graft

Cited by 43 publications

References 17 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?

What Clinimetric Evidence Exists for Using Hip-specific Patient-reported Outcome Measures in Pediatric Hip Impingement?

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

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