Abstract
An ischemic necrosis of the femoral head was induced in 15 mongrel adult dogs using the technique described by Gartsman et al. [10]. Five weeks later, a free vascularized rib graft was transferred into the previously induced ischemic femoral head. High resolution computed tomographic scanning was used to evaluate revascularization 4, 8 and 12 weeks after grafting. The femoral head exhibited new vessel formation throughout the study. Arterial terminal branches arising from the rib graft medullary and periosteal circulations extended beyond the rib graft, entered the head, and reached the subchondral plate. Even where the rib graft did not replenish the central core of the head, there was vascular supply from the grafted bone's vascular tree. These results suggest that a free vascularized bone graft is able to revascularize an experimentally induced ischemic femoral head necrosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bailey JP, Miller ME (1988) Osteonecrosis of the femoral head: treatment before collapse. A critical review. Adv Orthop Surg 12:55
Calandruccio R, Hungerford DS, Kenzora JE, Steinberg ME, Meyers MH (1987) Symposium on osteonecrosis of the femoral head. Contemp Orthop 14:119
Camp JF, Colwell CW (1986) Core decompression of the femoral head for osteonecrosis. J Bone Joint Surg (Am) 68A:1313
Chen ZW, Zhang GJ, Qiu HB (1987) Vascularized pedicle iliac crest graft as treatment for aseptic necrosis of femoral head. In: Urbaniak JR (ed) Microsurgery for major limb reconstruction. Mosby, St Louis, p 185
Cruess RL (1986) Osteonecrosis of bone. Current concepts as to etiology and pathogenesis. Clin Orthop 208:30
Dunn AW, Grow T (1977) Aseptic necrosis of the femoral head. Treatment with bone grafts of doubtful value. Clin Orthop 122:249
Enneking WF (1987) Rational treatment of nontraumatic aseptic necrosis of the femoral head. In: Urbaniak JR (ed) Microsurgery for major limb reconstruction. Mosby, St Louis, p 205
Fujimaki A, Yamauchi Y (1983) Vascularized fibular grafting for treatment of aseptic necrosis of the femoral head. Preliminary results in four cases. Microsurgery 4:17
Gantz R (1989) Pedicled autograft and osteotomy in revascularization of the femoral head. In: Aebi M, Regazzoni P (eds) Bone transplantation. Springer, Berlin Heidelberg New York, p 241
Gartsman G, Weiland AJ, Moore JR, Randolph MA (1985) Blood vessel implantation into ischemic bone. J Reconstr Microsurg 1:215
González del Pino J, Gómez Castresana F, Benito M, Weiland AJ (in press) Role of free Vascularized bone grafts in the experimentally induced ischemic necrosis of the femoral head. J Reconstruct Microsurg
González del Pino J, Gómez Castresana F, Galindo E, Rodriguez Merchan C (1988) Tratamiento de la necrosis isquémica de la cabeza femoral. In: González del Pino J (ed) La necrosis isquémica de la cabeza femoral. Garsi, Madrid, p 99
González del Pino J, Knapp K, Gómez Castresana F, Benito M, Gutierrez de la Camara A, Canosa R, de Miguel E (1988) Vascular medullary patency in free Vascularized bone grafts: CT scan experimental study. J Reconstr Microsurg 4:271
Hopson CN, Siverhus SW (1988) Ischemic necrosis of the femoral head. Treatment by core decompression. J Bone Joint Surg (Am) 70A:1048
Judet H, Judet J, Gilbert A, Garcia R (1987) Traitement des nécroses idiopathiques de la tête fémorale par greffon péronier vascularisé. Bilan après 7 ans d'expérience. Rev Chir Orthop 73:209
Kenzora JE (1985) Treatment of idopathic osteonecrosis. The current philosophy and rationale. Orthop Clin North Am 16:717
Lane JM, Sandhu HS (1987) Current approaches to experimental bone grafting. Orthop Clin North Am 18:213
Leung PC (1987) Use of Vascularized pedicle iliac crest graft in treatment of ischemic necrosis of femoral head. In: Urbaniak JR (ed) Microsurgery for major limb reconstruction. Mosby, St Louis, p 200
Maistrelli G, Fusco U, Avai A, Bombelli R (1988) Osteonecrosis of the hip treated by intertrochanteric osteotomy. A four to 15-year follow-up. J Bone Joint Surg (Br) 70B:761
Masquelet A, Nordin J, Guinot A (1985) Vascularized transfer of the adductor magnum tendon and its osseous insertion. A preliminary report. J Reconstr Microsurg 1:169
Masuda T, Matsuno T, Hasegawa I, Kanno T, Ichioka Y, Kaneda K (1988) Results of transtrochanteric rotational osteotomy for nontraumatic osteonecrosis of the femoral head. Clin Orthop 228:69
Meyers MH (1988) Osteonecrosis of the femoral head. Pathogenesis and long term results of treatment. Clin Orthop 231:51
Rindell K, Solonen KA, Lindholm TS (1989) Results of treatment of aseptic necrosis of the femoral head with vascularized bone graft. Ital J Orthop Traum 15:145
Solomon L (1985) Mechanism of idiopathic osteonecrosis. Orthop Clin North Am 16:655
Tooke SMT, Amstutz HC, Hedley AK (1987) Results of transtrochanteric rotational osteotomy for femoral head osteonecrosis. Clin Orthop 224:150
Tooke SMT, Nugent PJ, Bassett LW, Nottingham P, Mirra J, Jinnah R (1988) Results of core decompression for femoralead osteonecrosis. Clin Orthop 228:99
Urbaniak JR (1987) Aseptic necrosis of the femoral head treated by Vascularized fibular graft. In: Urbaniak JR (ed) Microsurgery for major limb reconstruction. Mosby, St Louis, p 178
Warner JJP, Philip JH, Brodsky GL, Thornhill TS (1987) Studies of nontraumatic osteonecrosis. The role of core decompression in the treatment of nontraumatic osteonecrosis of the femoral head. Clin Orthop 225:104
Weiland AJ, Phillips TW, Randolph MA (1984) Bone grafts. A radiologic, histologic and biomechanical model comparing autografts, allografts and free Vascularized bone grafts. Plast Reconstr Surg 74:368
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
González del Pino, J., Knapp, K., Gómez Castresana, F. et al. Revascularization of femoral head ischemic necrosis with vascularized bone graft: a CT scan experimental study. Skeletal Radiol. 19, 197–202 (1990). https://doi.org/10.1007/BF00204095
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF00204095