Organ Transplantation Research Today is a free monthly online journal that collates and summarizes the latest research about Organ Transplantation, including details on risks, prognosis, procedure, surgery. | ||||||||
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Long-term followup of vascularized fibular grafting for femoral head necrosis.Yoo MC, Kim KI, Hahn CS, Parvizi J Department of Orthopaedic Surgery, Center for Joint Diseases, East-West Neo Medical Center, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Korea. hipsurgeon@hanmail.net Vascularized fibular grafting has been used for treatment of osteonecrosis of the femoral head and although some reports demonstrate successful short- to mid-term outcomes, long-term results are still unknown. We retrospectively reviewed 135 patients (151 hips) who underwent vascularized fibular grafting for osteonecrosis of the femoral head. One-hundred and ten patients (124 hips) were followed for a minimum 10 years (mean, 13.9 years; range, 10-23.7 years). The mean Harris hip score improved from 72 to 88. At the latest followup, we found improved or unchanged radiographs in 37 of 59 hips initially Stage II hips and 39 of 65 Stage III hips. Thirteen hips (13 patients) (10.5%) failed treatment and underwent total hip arthroplasty. The location and size of the necrotic lesion and the patient's age influenced long-term survival of the graft. Postoperative complications included clawing of the big toe in 17 patients, partial peroneal nerve palsy in two, and superficial infection in two. Subtrochanteric fracture occurred in two hips. The data suggest free vascularized fibular grafting was successful in maintaining joint function and delaying the need for joint replacement procedure. Graft survival was associated with the patient's age and size and location of the lesion but not etiology and stages of the disease. Published 8 April 2008 in Clin Orthop Relat Res, 466(5): 1133-40.
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