title: Free vascularised fibular grafting with OsteoSet®2 demineralised bone matrix versus autograft for large osteonecrotic lesions of the femoral head.
abstract: The aim of this study was to compare the safety and efficacy of OsteoSet®2 DBM with autologous cancellous bone in free vascularised fibular grafting for the treatment of large osteonecrotic lesions of the femoral head. Twenty-four patients (30 hips) with large osteonecrotic lesions of the femoral head (stage IIC in six hips, stage IIIC in 14, and stage IVC in ten, according to the classification system of Steinberg et al.) underwent free vascularised fibular grafting with OsteoSet®2 DBM. This group was retrospectively matched to a group of 24 patients (30 hips) who underwent free vascularised fibular grafting with autologous cancellous bone during the same time period according to the aetiology, stage, and size of the lesion and the mean preoperative Harris hip score. A prospective case-controlled study was then performed with a mean follow-up duration of 26 months. The results show no statistically significant differences between the two groups in overall clinical outcome or the radiographic assessment. Furthermore, no adverse events related to the use of the OsteoSet®2 DBM were observed. The results demonstrate that OsteoSet®2 DBM combined with autograft bone performs equally as well as that of autologous bone alone. Therefore, OsteoSet®2 DBM can be used as a safe and effective graft extender in free vascularised fibular grafting for large osteonecrotic lesions of the femoral head.
authors.affiliation: Department of Orthopaedics, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Feng
authors.forename: Shanzhi
authors.initials: S
authors.lastname: Wang
authors.forename: Dongxu
authors.initials: D
authors.lastname: Jin
authors.forename: Jiagen
authors.initials: J
authors.lastname: Sheng
authors.forename: Shengbao
authors.initials: S
authors.lastname: Chen
authors.forename: Xiangguo
authors.initials: X
authors.lastname: Cheng
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000295:instrumentation / Q000379:methods*; D018775:Bone Demineralization Technique; D001857:Bone Matrix / Q000637:transplantation*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005271:Femur Head Necrosis / Q000473:pathology / Q000601:surgery*; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D006304:Health Status; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D055815:Young Adult