[Comparison of total hip replacement and transplantation of vascularized bone graft in treating late ischemic necrosis of the femoral head].
OBJECTIVE
To compare the effects and indications of total hip replacement (THR) and transplantation of vascularized bone graft in treating late ischemic necrosis of the femoral head.


METHODS
From March 1986 to March 1993, 81 patients with late ischemic necrosis underwent treatment. Of 81 patients, 59 patients who suffered in unilateral hip were divided into 2 groups: 26 underwent total hip replacement and 33 underwent transplantation of vascularized bone graft. There was no significant difference in the Harris-scores of the two groups before operations (P>0.05). The Harris hip scores were compared between different ages (<30 years, 31-50 years, and >51 years) in two groups.


RESULTS
The follow-up ranged from 10 years and 3 months to 16 years and 5 months (15 years and two months on average). The changes of Harris-scores of the two groups after operations had significant difference in initial stage (P<0. 05), but had no significant difference in the long term (P>0.05). The change of Harris-scores of patients who underwent total hip replacement had no significant difference between different ages (P>0.05), but that of patients who underwent transplantation of vascularized bone graft had significant difference between different ages (P<0.05). Both groups had satisfactory effects in treating late ischemic necrosis of the femoral head.


CONCLUSIONS
Both methods are effective in treating late ischemic necrosis of the femoral head. Total hip replacement can be more effective in senior patients. Transplantation of vascularized bone can be more effective in young patients.
Zhao
Dewei
D
Department of Orthopedics, Zhongshan Hospital, Dalian University, Dalian Liaoning, 116001, P. R. China gksys@126.com
Zhang
Yao
Y
Wang
Weiming
W
Lu
Jianmin
J
Zhang
Kemin
K
Yu
Xiaoguang
X
Sun
Qiang
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005269:Femur / Q000637:transplantation; D005271:Femur Head Necrosis / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome