Free vascularized fibular grafting in treatment of femoral head osteonecrosis

doi:10.12307/2024.080

Abstract

Abstract: BACKGROUND: Free vascularized fibular grafting is an effective hip preservation treatment for femoral head osteonecrosis, but its influencing factors are still controversial.
OBJECTIVE: To explore the clinical efficacy of free vascularized fibular grafting for femoral head osteonecrosis, and the influence of the etiology and severity of femoral head osteonecrosis on its efficacy.
METHODS: Clinical data and clinical efficacy scores of preoperative and postoperative hip joints in 63 patients with femoral head osteonecrosis (73 cases of hip) were enrolled. The subjects were divided into three groups by the etiological classification criteria of femoral head osteonecrosis, including glucocorticoid-associated, alcohol-associated, and idiopathic groups, and also were divided into three groups by the Ficat classification system, including Ficat II, Ficat III and Ficat IV groups. The effects of etiological classification and lesion degree on the clinical efficacy of free vascularized fibular grafting for femoral head osteonecrosis were analyzed.
RESULTS AND CONCLUSION: (1) The visual analog scale scores in all periods after free vascularized fibular grafting for femoral head osteonecrosis were significantly decreased compared with preoperative data (P < 0.001), and Harris scores were significantly increased compared with preoperative data (P < 0.001). (2) In the glucocorticoid-associated, alcohol-associated, and idiopathic groups, except the glucocorticoid-associated group, postoperative Harris scores were significantly increased 2 and 3 years after surgery in other groups compared with preoperative data (P < 0.05). (3) In the three groups of Ficat II, Ficat III, and Ficat IV, the postoperative Harris scores of Ficat II and Ficat III groups were significantly increased compared with preoperative data (P < 0.05), while the difference was not significant in the Ficat IV group between the preoperative and postoperative data (P > 0.05). (4) These results indicate that the clinical effect of free vascularized fibular grafting for the femoral head osteonecrosis is significant, which can reduce hip pain and improve hip joint function. It may not be affected by the etiology, but by the severity of the femoral head osteonecrosis.

Key words: femoral head osteonecrosis, hip preservation, free fibular grafting, etiology classification, Ficat stage, clinical efficacy, mechanical property, biological property

CLC Number:

Huang Jie, Shi Yanghua, Tan Zhen, Bo Zhandong. Free vascularized fibular grafting in treatment of femoral head osteonecrosis[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(21): 3373-3379.

Figures/Tables 5

References

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