Revascularization of the femoral head in osteonecrosis.
Osteonecrosis of the femoral head accounts for as many as 18% of total hip arthroplasties performed in western countries. The young age of affected patients and the potentially poor outcome have sparked an interest in alternative treatment modalities. Extracapsular placement of a vascularized fibular graft in the subchondral region of the femoral head has shown great promise as a treatment option. The authors have used this procedure in the treatment of 646 symptomatic hips, of all grades of osteonecrosis, with a follow-up of 1 to 17 years. The resultant 10-year survival rate of greater than 80% suggests that this procedure may be preferable to total hip arthroplasty for the young patient with osteonecrosis of the femoral head.
Department of Surgery, Duke University Medical Center, Durham, NC.
J R
JR
Urbaniak
E J
EJ
Harvey
D000792:Angiography; D016025:Bone Transplantation / Q000379:methods* / Q000401:mortality; D005270:Femur Head / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D015996:Survival Rate