title: Femoral head bone viability after free vascularized fibular grafting for osteonecrosis: SPECT/CT study.
abstract: OBJECTIVE
  To evaluate femoral head bone viability following free vascularized fibular grafting (FVFG) for osteonecrosis using SPECT/CT imaging.
  
  
  METHODS
  Ten hips (9 patients) with osteonecrosis of the femoral head (ONFH) undergoing FVFG were prospectively enrolled. Four cases showed ARCO stage II, while six showed ARCO stage III. The mean age at surgery was 15.7 years (range, 13-22 years). Hip Harris Score (HHS) was measured pre- and post-operative. Bone scintigraphy with SPECT/CT was performed at 2 weeks and 6 months following surgery.
  
  
  RESULTS
  Mean follow-up was 4.0 years (range, 2-5.9 years). Mean HHS increased from 37.2 to 92.3. SPECT/CT findings revealed a progressive increase of femoral head uptake in all cases, suggesting subchondral graft bone viability. No progressive deformation of the femoral head was evidenced in radiographic evaluation at final follow-up.
  
  
  CONCLUSIONS
  This study demonstrates FVFG's capacity for revitalizing femoral head subchondral bone grafting in patients with ONFH, surgically treated following Urbaniak's technique. © 2015 Wiley Periodicals, Inc. Microsurgery 36:573-577, 2016.
authors.affiliation: Pediatric Orthopaedic Unit, Hospital Universitari Vall D'hebron, Barcelona, Spain.
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Fontecha
authors.affiliation: Nuclear Medicine Department, Hospital Universitari Vall D'hebron, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Roca
authors.affiliation: Pediatric Radiology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Barber
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Menendez
authors.affiliation: Hip Surgery Unit, Hospital Universitari Vall D'hebron, Barcelona, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Collado
authors.affiliation: Radiology Department, UIME, Hospital Da Luz, Lisboa, Portugal.
authors.forename: Vasco V
authors.initials: VV
authors.lastname: Mascarenhas
authors.affiliation: Hand Surgery, Hospital Universitari Vall D'hebron, Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Barrera-Ochoa
authors.affiliation: Pediatric Hand Surgery and Microsurgery, Hospital Sant Joan De Deu. Universitat De Barcelona, Spain. drsoldado@cirugiamanoinfantil.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Soldado
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging* / Q000601:surgery; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D016896:Treatment Outcome; D055815:Young Adult