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Pedicled Autograft and Osteotomy in Revascularization of the Femoral Head

Abstract

The incidence of idiopathic femoral head necrosis in general is increasing. This entity is found much more frequently in men than in women with the peak age between 20 and 40 years. Quite often both hips are involved. The pathophysiology is rather clear in posttraumatic conditions, but a more complex picture is involved in the idiopathic group. The currently favored etiology is that of a bone marrow fibrosis causing increased perivascular pressure [11]. There is a resultant necrotic segment which lies in the anterosuperior quadrant of the femoral head, an area which is supplied by terminal vessels and is exposed to the maximum mechanical load.

Keywords

Femoral Head Core Decompression Femoral Head Necrosis Bone Marrow Fibrosis Pedicle Graft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Baksi DP (1983) Treatment of post-traumatic avascular necrosis of the femoral head by multiple drilling and muscle-pedicle bone grafting. J Bone Joint Surg 65-B: 268Google Scholar
  2. 2.
    Bonfiglio M, Basdenstium MB (1958) Treatment by bone grafting of aseptic necrosis of the femoral neck and nonunion of the femoral neck. J Bone Joint Surg 40-A: 1329PubMedGoogle Scholar
  3. 3.
    Boyd RJ, Ault LL (1965) An experimental study of vascular implantation into the fernoral head. Surg Gynecol Obstet 121: 1009PubMedGoogle Scholar
  4. 4.
    Camera U (1954) Die biologische Haloplastik. Verh Dtsch Orthop Ges 42: 341Google Scholar
  5. 5.
    Ficat P, Arlet J (1977) Ischémie et nécrose osseouse. Masson, ParisGoogle Scholar
  6. 6.
    Frankel CJ, Derian PS (1962) The induction of subcapital femoral circulation by means of an autogenous muscle pedicle. Surg Gynecol Obstet 115: 473PubMedGoogle Scholar
  7. 7.
    Ganz R, Jakob RP (1980) Partielle avasculäre Hüftkopfnekrose: Flexionsosteotomie und Spongiosaplastik. Orthopäde 9: 265PubMedGoogle Scholar
  8. 8.
    Ganz R, Büchler U (1983) Overview of attempts to revitalize the dead head in aseptic necrosis of the femoral head — osteotomy and revascularisation. In: Hungerford DS (ed) The hip: proceedings of the eleventh open scientific meeting of The Hip Society. Mosby, St. Louis, p 296Google Scholar
  9. 9.
    Hori Y (1980) Revitalisierung des osteonekrotischen Hüftkopfes durch Gefässbündel-Transplantation. Orthopäde 9: 255PubMedGoogle Scholar
  10. 10.
    Hungerford DS (1979) Bone marrow pressure, venography and core decompression in ischemic necrosis of the femoral head. In: Hungerford DS (ed) The hip: proceedings of the seventh open scientific meeting of The Hip Society. Mosby, St. Louis, p 218Google Scholar
  11. 11.
    Hungerford DS, Zizic TM (1983) Pathogenesis of ischemic necrosis of the femoral head. In: Hungerford DS (ed) The hip: proceedings of the eleventh open scientific meeting of The Hip Society. Mosby, St. Louis, p 249Google Scholar
  12. 12.
    Judet H, Judet J, Gilbert A (1981) Vascular microsurgery in orthopaedics. Int Orthop 5: 61PubMedCrossRefGoogle Scholar
  13. 13.
    Judet R, Judet J, Lamois B, Gubler JP (1966) Essaie de révascularisation expérimentale de la tête fémorale. Rev Chir Orthop 52: 277PubMedGoogle Scholar
  14. 14.
    Kerboull M (1973) L’ostéotomie intertrochantérienne dans le traitement de la nécrose idiopathique de la tête fémorale. Rev Chir Orthop (suppl 1 ) 59: 52PubMedGoogle Scholar
  15. 15.
    Lee CK, Rehmatullah N (1981) Muscle-pedicle bone graft and cancellous bone graft for the “silent hip” of idiopathic ischemic necrosis of the femoral head in adults. Clin Orthop 158: 185PubMedGoogle Scholar
  16. 16.
    Merle d’ Aubigné R, Postel M, Mazabraud A, Massias P, Guegneu J (1965) Idiopathic necrosis of the femoral head in adults. J Bone Joint Surg 47-B: 612Google Scholar
  17. 17.
    Merle d’Aubigné R (1970) Cotation chiffré de la fonction de la hanche. Rev Chir Orthop 56: 481Google Scholar
  18. 18.
    Palazzi C, Xicoy J (1975) The pediculate bone grafts as treatment for the aseptic necrosis of the femoral head. Arch Orthop Unfall Chir 83: 115CrossRefGoogle Scholar
  19. 19.
    Patterson RJ, Bickel WH, Dahlin DC (1964) Idiopathic avascular necrosis of the head of the femur. J Bone Joint Surg 46-A: 267PubMedGoogle Scholar
  20. 20.
    Wagner H (1967) Aetiologie, Pathogenese, Klinik und Therapie der idiopathischen Hüftkopfnekrose. Verh Dtsch Orthop Ges 54: 224Google Scholar

Copyright information

© Springer-Verlag, Berlin Heidelberg 1989

Authors and Affiliations

  • R. Ganz
    • 1
  1. 1.Department of Orthopaedic SurgeryUniversity of BerneBerneSchweiz

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