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Outcomes of total hip arthroplasty after failed free vascularized fibular grafting for osteonecrosis of the femoral head

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Total hip arthroplasty (THA) after vascularized fibular grafting (VFG) is technically demanding with poorer outcomes compared to primary THA in patients with osteonecrosis of the femoral head (ONFH). The purpose of this study was to compare the outcomes of THA after VFG after removal of the graft with that of primary THA.

Methods

ONFH patients treated by VFG at a single institution were studied retrospectively. THAs after VFG performed by single arthroplasty surgeon with a single type of THA prosthesis were enrolled in the study. A control cohort of patients was created by 1:1 matching with the THA after VFG cohort according to age, gender, and American Society of Anesthesiology (ASA) score from ONFH patients treated by primary THA. Early and long-term outcomes were compared between the two groups.

Results

A total of 24 hips were included in the THA after VFG group and compared with 24 primary THA hips. No significant difference was noted in stem position. The THA after VFG group had increased blood loss and longer duration of operation time. There were two cases of intraoperative femur fractures in the THA after VFG group. The femoral stem of both groups were stable, with no cases of revision, and similar HHS scores at the last follow-up.

Conclusion

THA after VFG may have similar short to midterm outcomes with primary THA after removal of the residual abutting bone graft and correct positioning of the femoral stem.

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Data and material availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Yoon-Vin Kim, Joo-Hyoun Song, Young-Wook Lim, Woo-Lam Jo, Se-Won Lee, Wu-Seok Shin & Kee-Haeng Lee

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  1. Yoon-Vin Kim
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  2. Joo-Hyoun Song
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  3. Young-Wook Lim
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  4. Woo-Lam Jo
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  5. Se-Won Lee
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  6. Wu-Seok Shin
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  7. Kee-Haeng Lee
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Contributions

All authors contributed equally to the study.

Corresponding author

Correspondence to Kee-Haeng Lee.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the Catholic University of Korea, Bucheon St. Mary’s Hospital (January 11, 2022, No. HC22RESI0001).

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Kim, YV., Song, JH., Lim, YW. et al. Outcomes of total hip arthroplasty after failed free vascularized fibular grafting for osteonecrosis of the femoral head. Eur J Orthop Surg Traumatol 33, 2347–2352 (2023). https://doi.org/10.1007/s00590-022-03440-7

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