Indications for Free Vascularized Fibular Grafting in Osteonecrosis Treatment
Author Information
Author(s): Kawate Kenji, Yajima Hiroshi, Sugimoto Kazuya, Ono Hiroshi, Ohmura Tetsuji, Kobata Yasunori, Murata Keiichi, Shigematsu Koji, Kawamura Kenji, Kawahara Ikuo, Maegawa Naoki, Tamai Katsuya, Takakura Yoshinori, Tamai Susumu
Primary Institution: Nara Medical University, Japan
Hypothesis
The study aimed to determine the indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head.
Conclusion
Small osteonecrosis without preoperative collapse is the major indication for free vascularized fibular grafting, while steroid-induced osteonecrosis is a relative contraindication.
Supporting Evidence
- The average preoperative Harris hip score was 56 points and improved to 78 points at the latest follow-up.
- Forty-seven hips (67%) were rated good to excellent after the procedure.
- The overall survivorship rate was 83% at 7 years post-surgery.
- Steroid-induced osteonecrosis was significantly associated with poorer outcomes.
Takeaway
This study looked at how to use a special bone graft to help people with a certain type of hip problem, finding that smaller issues are better for this treatment.
Methodology
The study followed 71 hips in 60 patients for a minimum of 3 years, assessing outcomes using the Harris hip-scoring system and radiographic evaluations.
Potential Biases
Potential biases may arise from the retrospective design and the specific patient selection criteria.
Limitations
The study had a relatively small sample size and was retrospective in nature.
Participant Demographics
The participants included 60 patients, 45 men and 15 women, with an average age of 39 years.
Statistical Information
P-Value
0.000000016
Confidence Interval
95% confidence interval (range, 74–92%)
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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