Treatment of avascular necrosis of the femoral head utilising free vascularised fibular graft: a systematic review.
We conducted a systematic review to determine whether the literature supports the use of free vascularised fibular graft (FVFG) over other salvage procedures for the treatment of avascular necrosis (AVN) of the femoral head, and if there are patient-specific and defect-specific factors that may predict better outcomes after FVFG. Fifteen total studies were identified for inclusion. Three comparative studies showed an overall statistically significant superiority of FVFG over NVFG; two comparative studies demonstrated FVFG better than core decompression. One study show a better but not statistically significant superiority of FVFG comparing with vascularised iliac pedicle bone graft procedures, likely due to small sample size. This review suggests that vascularised fibular grafting is a better treatment option than core decompression and nonvascularised fibular grafting.
1 OSU Sports Medicine, The Ohio State University, Columbus, Ohio - USA.
Syed Ahmed
SA
Ali
Jonathan M
JM
Christy
Michael J
MJ
Griesser
Hisham
H
Awan
Xueliang
X
Pan
Thomas J
TJ
Ellis
D016025:Bone Transplantation / Q000379:methods*; D005271:Femur Head Necrosis / Q000601:surgery*; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D016896:Treatment Outcome