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Vascularized Fibular Grafting for Osteonecrosis of the Femoral Head With Unusual Indications

  • Symposium: Molecular and Surgical Advances in Osteonecrosis
  • Published:
Clinical Orthopaedics and Related Research

Abstract

We retrospectively reviewed the charts of 154 patients of various subgroups treated with the free vascularized fibular graft procedure for osteonecrosis of the femoral head (ONFH), evaluating pre- and postoperative Harris hip scores, hip range of motion, radiographs, and number of conversions to total hip arthroplasty (THA). Patients were followed a minimum of 1 year (mean, 6.8 years, range, 1 to 19 years). Athletes and patients with pyarthrosis-related osteonecrosis had high Harris hip scores at final review with scores of 94 and 97, respectively. Patients with ONFH after a slipped capital femoral epiphysis or following pregnancy had a low conversion rate to THA at 6% and 8%, respectively. Twenty-five percent of patients with transplant-related osteonecrosis of the femoral head were converted to THA at an average of 2.7 years. However, with select subsets of patients (athletes, pregnancy, organ transplant, femoral neck non-union, slipped capital femoral epiphysis, infection) the FVFG can result in a high rate of success.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dawn Pedrotty, PhD, MS, and Jennifer Friend for their assistance in gathering the data for this paper.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Duke University Medical Center, 3116 North Duke Street, Durham, NC, 27704, USA

    J. Mack Aldridge III MD & James R. Urbaniak MD

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  1. J. Mack Aldridge III MD
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  2. James R. Urbaniak MD
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Correspondence to J. Mack Aldridge III MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Aldridge, J.M., Urbaniak, J.R. Vascularized Fibular Grafting for Osteonecrosis of the Femoral Head With Unusual Indications . Clin Orthop Relat Res 466, 1117–1124 (2008). https://doi.org/10.1007/s11999-008-0201-z

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  • DOI: https://doi.org/10.1007/s11999-008-0201-z

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