title: Physicians and health professionals with osteonecrosis of the femoral head: results of management with free vascularized fibular grafting.
abstract: Outcomes of free vascularized fibular grafting for the treatment of femoral head (FH) osteonecrosis between 1) physicians/health professionals and 2) a comparison group of the population at large was performed. Twenty-one healthcare providers (32 hips) were treated: 10 stage II, 7 stage III, and 15 stage IV were treated over a 13-year period. The control group consisted of 1257 hips: 221 with stage II, 220 with stage III, and 816 with stage IV. All patients were followed for a minimum of 2 years. The end point for failure was conversion to total hip arthroplasty. The physician group demonstrated a high degree of postoperative compliance. The conversion rate to total hip arthroplasty was significantly lower in the physician group (6.25%) compared to the control group (20.6%). Outstanding postoperative compliance appears to be related to favorable outcomes. Further evaluation of failure in both groups may help better understand FH osteonecrosis and improved patient outcomes.
authors.affiliation: Duke University Medical Center, Division of Orthopaedic Surgery, Durham, NC 27710, USA. rizzo001@mc.duke.edu
authors.forename: Marco
authors.initials: M
authors.lastname: Rizzo
authors.forename: Philip E
authors.initials: PE
authors.lastname: Clifford
authors.forename: Eunice E
authors.initials: EE
authors.lastname: Gunneson
authors.forename: James R
authors.initials: JR
authors.lastname: Urbaniak
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery*; D005500:Follow-Up Studies; D006281:Health Occupations; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010349:Patient Compliance; D010820:Physicians; D016896:Treatment Outcome