title: Midterm results of treating femoral head osteonecrosis with autogenous corticocancellous bone grafting.
abstract: BACKGROUND
  Appropriate treatment of osteonecrosis of femoral head (ONFH) remains challenging.
  
  
  OBJECTIVE
  Here, we report the results of treating these patients with auto-corticocancellous bone graft from iliac crest to overcome the need for early total hip arthroplasty (THA).
  
  
  METHODS
  There were 132 hips (96 patients) with ONFH. Association Research Circulation Osseous (ARCO) type II and III underwent auto-corticocancellous bone grafting from the iliac crest in the current prospective study. Before the operation and in the final postoperative visit, the pain intensity using visual analogue scale (VAS), range of hip motions and Harris hip score (HHS) were determined and compared. Patients were followed for 48.5 ± 17.9 months.
  
  
  RESULTS
  The shape of head and the joint space were preserved in 120 hips (90.9%). There were 12 hips in which the disease progressed to grade IV and resulted in THA in 10 of them. The pain intensity significantly decreased (6.3 ± 4.1 vs. 1.4 ± 2) and HHS (35.8 ± 15.3 vs. 79.5 ± 16.2) and range of motion (ROM) significantly improved after the operation (P < 0.001).
  
  
  CONCLUSIONS
  Necrotic bone removal and filling the femoral head cavity with auto-corticocancellous bone graft from iliac crest is an effective femoral head preserving method in treating patients with precollapse stages of ONFH and preventing the need for early THA, especially in young active populations.
authors.affiliation: Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Vahid Farahmandi
authors.affiliation: Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Abbasian
authors.affiliation: Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Safdari
authors.affiliation: Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emami Moghaddam Tehrani
keywords: Bone Graft; Femoral Head; Osteonecrosis