title: [Demineralised cortical bone allografting in femoral head necrosis].
abstract: We report the clinical and biological results of the surgical treatment of a femoral head osteonecrosis, Ficat classification stage III, in a 53 year old patient. The procedure included core decompression followed by insertion of a superficial demineralised and processed fibular bone allograft. A cemented total hip arthroplasty was performed at nine years follow-up. The histomorphological study of the excised femoral head showed the incorporation of the bone allograft. Although core decompression of the femoral head has been used in precollapse lesions, Ficat stage I and II, its combination with fibular allografting allowed the postponement of total hip prosthesis implantation for nine years. In this clinical case, the implantation of a total hip arthroplasty, as a primary surgical treatment, would also have been an alternative procedure, if it had only been considered the patient;s age and osteonecrosis extension.
authors.affiliation: Serviço de Ortopedia dos Hospitais da Universidade de Coimbra, 3000-075 Coimbra, Portugal. fernandojudas@gmail.com
authors.forename: Fernando
authors.initials: F
authors.lastname: Judas
authors.forename: Portela
authors.initials: P
authors.lastname: da Costa
authors.forename: Jorge
authors.initials: J
authors.lastname: Garcia
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Saavedra
mesh_terms: D005260:Female; D005271:Femur Head Necrosis / Q000601:surgery*; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures