title: Hip arthroplasty after failed free vascularized fibular grafting for osteonecrosis in young patients.
abstract: This study reports the results of total hip arthroplasty (THA) for osteonecrosis after failed free vascularized fibular grafting (FVFG) at a 5-year minimum follow-up. In this study, 73 patients (89 THA) were treated for failed FVFG, and survival of THA was discussed. Clinical outcome was measured using a pain and function survey (possible 91 points) in 84 hips and Harris Hip scores (HHS, 100 possible points) for 52 hips. Survival was 94.4% at 5 years, 85.4% at 10 years, and 82% overall. Average HHS at final follow-up improved to 77.5 (P <.05). The average clinical result after THA was 68 of 91 points. In this study, 58% of patients had a good or excellent HHS. The overall revision rate for proximal ingrowth stems was 13% at an average follow-up of 9.1 years. Only 4 patients required stem revision for loosening (7.4%). THA after FVFG provides improved functional results comparable to the published results of primary THA in osteonecrosis in young patients.
authors.affiliation: Joint Implant Surgeons, Columbus, Ohio 43215, USA.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Berend
authors.forename: Eunice
authors.initials: E
authors.lastname: Gunneson
authors.forename: James R
authors.initials: JR
authors.lastname: Urbaniak
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Vail
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip; D016009:Chi-Square Distribution; D020099:Coated Materials, Biocompatible; D005260:Female; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible