title: Pain relief following osteonecrosis of the femoral head treated by free vascularized fibular grafting.
abstract: BACKGROUND
  Pain is the core and basic problem in the treatment of osteonecrosis of the femoral head (ONFH). However, it is unclear about the status of pain relief following ONFH treated by free vascularized fibular grafting (FVFG) and the level of pain relief contributed to clinical results. Therefore, we designed a consecutive and prospective study to investigate post-operative pain relief in the treatment of osteonecrosis of the femoral head by FVFG.
  
  
  METHODS
  One hundred and fifty-one patients with unilateral osteonecrosis of the femoral head were enrolled consecutively for current prospective study from January to August of 2006. Patients were managed by modified technique of free vascularized fibular grafting. Pre-operative, post-operative Harris hip score (HHS) and Harris pain score (HPS) were recorded and compared statistically, meanwhile, correlation between disease severity and Harris hip score, Harris pain score were revealed.
  
  
  RESULTS
  All patients had an average follow-up of 54.3 months. Post-operative Harris hip score could be improved from 73.7 to 83.5 averagely in stage-II patients, 64.6 to 78.9 in stage-III, and 53.6 to 72.4 in stage-IV. As for Harris pain score, it was elevated from 28.8 to 38.6 in stage-II patients, 25.5 to 36.6 in stage-III, and 21.8 to 34.2 in stage-IV. Taken together, HHS was improved from 67.7 to 80.3 (ΔHHS = 12.6), and HPS was improved from 26.6 to 37.3 (ΔHPS = 10.7) averagely.
  
  
  CONCLUSIONS
  Harris pain score could be employed to monitor prognosis of osteonecrosis of the femoral head treated by free vascularized fibular grafting. Improvement of HPS was the heaviest contributor to elevation of HHS, and both of them conceived of a close relationship with disease severity.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, 200233, China.
authors.forename: Sheng-Bao
authors.initials: SB
authors.lastname: Chen
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, 200233, China. gaoyoushui@gmail.com.
authors.forename: You-Shui
authors.initials: YS
authors.lastname: Gao
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, 200233, China.
authors.forename: Zhen-Hong
authors.initials: ZH
authors.lastname: Zhu
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, 200233, China.
authors.forename: Dong-Xu
authors.initials: DX
authors.lastname: Jin
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, 200233, China.
authors.forename: Xiang-Guo
authors.initials: XG
authors.lastname: Cheng
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Jiao Tong University, Shanghai, 200233, China. zhangchangq@yahoo.com.cn.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Zhang
keywords: Free vascularized fibular grafting; Harris hip score; Musculoskeletal pain; Osteonecrosis of the femoral head