Treatment of avascular necrosis of the hip by a non-vascularised cortical graft.
J Bone Joint Surg Br
; 88(4): 460-6, 2006 Apr.
Article
em En
| MEDLINE
| ID: mdl-16567779
ABSTRACT
This retrospective study describes the long-term results of core decompression and placement of a non-vascularised bone graft in the management of avascular necrosis of the femoral head. We treated 80 hips in 65 patients, 18 by a cortical tibial autograft and 62 by a fibular allograft. The mean age of the patients was 36 years (SD 13.2). A total of 78 hips were available for evaluation of which pre-operatively six were Ficat-Arlet stage 0, three stage I, 31 stage IIA, 16 stage IIB, 13 stage III and nine stage IV. A total of 34 hips (44%) were revised at a mean of four years (SD 3.8). Survivorship analysis using a clinical end-point showed a survival rate of 59% five years after surgery. We found a significant difference (p = 0.002) in survivorship, when using a clinical and radiological end-point, between the two grafts, in favour of the tibial autograft. We considered this difference to be the result of the better quality and increased volume of tibial bone compared with that from the trochanteric region used with the fibular allograft. This is a relatively simple, extra-articular and reproducible procedure. In our view core decompression, removal of the necrotic tissue and packing of the cancellous grafts into the core track are vital parts of the procedure.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tíbia
/
Transplante Ósseo
/
Necrose da Cabeça do Fêmur
/
Fíbula
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Bone Joint Surg Br
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Holanda