title: Vascularized bone grafting fixed by biodegradable magnesium screw for treating osteonecrosis of the femoral head.
abstract: Hip-preserving surgery with vascularized bone graft implantation has been widely practiced in treating osteonecrosis of the femoral head (ONFH). However, the current approach presents a drawback, in which the implanted bone graft without screw fixation may slip or exhibit a certain degree of displacement postoperatively. This study was designed to investigate the application potential of biodegradable magnesium (Mg) screws for the fixation of vascularized bone graft in ONFH patients. Forty-eight patients were randomly divided into two groups: the Mg screw group (vascularized bone grafting fixed by Mg screws) and the control group (vascularized bone grafting without fixation). During 12 month follow-up period after surgery, treatment outcomes in patients were assessed by multiple imaging techniques including x-ray and computed tomography (CT) scanning as well as functional recovery Harris hip score (HHS). The temporal changes in serum levels of Mg, Ca, and P as well as in vivo degradation rate of Mg screws were determined. The absence of potential adverse effects induced by degradation products from Mg screws on surrounding bone tissue was validated via CT imaging analysis. HHS was significantly improved in the Mg screw group when compared to the control group. X-ray imaging analysis showed that the screw shape did not show significant alteration due to the diameter of Mg screws measured with approximate 25% reduction within 12 months post-surgically. The postoperative serum levels of Ca, Mg, and P, which are relevant for liver and kidney function, were all within normal physiological range in all patients of both groups. The use of biodegradable Mg screws may provide a promising bone graft-screw fixation route in treating ONFH and present considerable potential for orthopedic applications.
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China. Electronic address: zhaodewei2000@163.com.
authors.forename: Dewei
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Shibo
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Faqiang
authors.initials: F
authors.lastname: Lu
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Benjie
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yang
authors.affiliation: Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: lingqin@cuhk.edu.hk.
authors.forename: Ling
authors.initials: L
authors.lastname: Qin
authors.affiliation: Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Yang
authors.affiliation: Dongguan Eontec Co., Ltd, Dongguan, China.
authors.forename: Yangde
authors.initials: Y
authors.lastname: Li
authors.affiliation: Dongguan Eontec Co., Ltd, Dongguan, China.
authors.forename: Weirong
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Simiao
authors.initials: S
authors.lastname: Tian
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Xiuzhi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Zongpu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Xinhui
authors.initials: X
authors.lastname: Xie
authors.affiliation: Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jiali
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
authors.forename: Junlei
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000494:pharmacology*; D015519:Bone Density; D001863:Bone Screws; D016025:Bone Transplantation; D002118:Calcium / Q000097:blood; D005260:Female; D005271:Femur Head Necrosis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D006801:Humans; D020007:Implants, Experimental; D008274:Magnesium / Q000097:blood / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D010758:Phosphorus / Q000097:blood; D011182:Postoperative Care; D011300:Preoperative Care; D013524:Surgical Flaps; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D001672:Biocompatible Materials; D010758:Phosphorus; D008274:Magnesium; D002118:Calcium
keywords: Biodegradability; Mg screw; Osteonecrosis of the femoral head; Vascularized bone graft