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J Reconstr Microsurg 2013; 29(06): 387-392
DOI: 10.1055/s-0033-1343836
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Free Vascularized Fibular Grafting Benefits Severely Collapsed Femoral Head in Concomitant with Osteoarthritis in Very Young Adults: A Prospective Study

Hao Ding
1   Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
,
You-Shui Gao
1   Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
,
Sheng-Bao Chen
1   Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
,
Dong-Xu Jin
1   Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
,
Chang-Qing Zhang
1   Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Weitere Informationen

Publikationsverlauf

24. August 2012

07. Dezember 2012

Publikationsdatum:
15. April 2013 (online)

    Lizenzen und Reprints

Abstract

Although free vascularized fibular grafting (FVFG) has been successfully employed for precollapsed osteonecrosis of the femoral head (ONFH), there are few reports concerning its radiographic and functional results for ONFH concomitant with osteoarthritis (OA) of the hip. In the current study, 12 patients with OA induced by traumatic ONFH were enrolled, with FVFG employed as the treatment protocol. The collapsed step of the cartilage surface was measured and compared with the postoperative value, and the Merle d'Aubigné scoring system was used to evaluate preoperative and postoperative status of the hip joint. The collapsed step disappeared, and sphericity of the femoral head could be restored at an average duration of 56 months postoperatively in seven patients. With regard to the severity of hip OA, six were improved to Grade 1 and one to Grade 2. In terms of functionality, all patients with a restored femoral head experienced postoperative improvement in pain relief, mobility, and functional capacity. The average Merle d'Aubigné score increased from 6.0 to 16.9 postoperatively (p < 0.001). In conclusion, for traumatic ONFH concomitant with OA, FVFG can confer benefits in the form of restoration of the contour of the femoral head and improvement in joint function.

Keywords

free vascularized fibular grafting - osteonecrosis of the femoral head - osteoarthritis - femoral neck fractures - young adults
 

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