Long-term Followup of Vascularized Fibular Grafting for Femoral Head Necrosis

Yoo, Myung-Chul; Kim, Kang‐Il; Hahn, Chung-Soo; Parvızı, Javad

doi:10.1007/s11999-008-0204-9

Cited by 105 publications

(95 citation statements)

References 33 publications

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“…There are multiple such treatment options directed toward preserving the femoral head and maintaining coxofemoral joint congruity to prevent or delay hip arthrosis [2,9]. Although technically complex, treatment by free vascularized fibular grafting (FVFG) is reportedly a biologic option for hip preservation that may last 20 years or longer [1,2,7,9,13,28]. It generally is accepted this intervention is more likely to result in hip preservation when performed before radiographic collapse of the femoral head [1,2,9,20,26].…”

Section: Introductionmentioning

confidence: 99%

“…First, in reported outcomes after FVFG, precollapse and postcollapse femoral heads have been grouped together when plotting graft survival and identifying risk factors for failure [19,[22][23][24][25][26]28]. Stage, size, and etiology have been identified as factors influencing the likelihood of hip preservation after FVFG [16,22,28], but it is not known whether these hold true in the specific subset of patients treated before bony collapse. Second, definitions of success and failure have been variable.…”

Section: Introductionmentioning

confidence: 99%

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The Vascularized Fibular Graft in Precollapse Osteonecrosis: Is Long-term Hip Preservation Possible?

Eward

Rineer²,

Urbaniak

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Results Forty-nine of 65 hips (75%) had surviving FVFG for at least 10 years. At last followup, 39 of 65 hips (60%) had surviving FVFG, with a mean graft survival time of 15 years (range, 10.5-26.1 years). Twenty-six of the 65 hips with FVFG (40%) underwent conversion to THA at a mean of 8 years postoperatively. Demographic factors, lesion size, additional procedures, and low preoperative function were not associated with changes in graft survivorship. Pain and function were similar in patients with surviving FVFG and patients who had conversion to THA. Patients with surviving FVFG were more likely to engage in impact sports or active events than were patients who had conversion to THA. Conclusions When patients with precollapse ONFH undergo FVFG, the majority have preservation of the hip lasting for greater than 10 years with low levels of pain and reasonable function. In patients who ultimately undergo conversion surgery to THA, the mean duration of hip preservation before conversion is 8 years. We continue to use FVFG for treating patients younger than 50 years with symptomatic, precollapse ONFH. Level of Evidence Level IV, therapeutic study. See Instructions to Authors for a complete description of levels of evidence.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Vascularized Fibular Graft in Precollapse Osteonecrosis: Is Long-term Hip Preservation Possible?

Eward

Rineer²,

Urbaniak

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…The advantage of FVFG lies in the combination of femoral head decompression, removal of necrotic lesion, introduction of osteoinductive cancellous bone, and vascularised cortical bone support of the subchondral surface [24]. There are multiple reports on the successful mid-and long-term outcomes of FVFG [7][8][9]. Zhang et al [8] used FVFG to treat 56 hips in 48 patients, with mean follow-up of 16 months.…”

Section: Discussionmentioning

confidence: 99%

“…The HHSs of all stages were improved, ranging from 11 to 13, and most femoral heads showed improvement (39 hips, 69.6%) or were at least unchanged (14 hips, 25.0%) on radiographs. Yoo et al [7] reported on 110 patients (124 hips) who underwent FVFG, with a minimum follow-up of ten years. Of these, 37 of 59 hips which were initially stage II hips and 39 of 65 stage III hips were found improved or unchanged radiographically at the latest follow-up, with mean HHS improved from 72 to 88.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of osteonecrosis of the femoral head in lymphoma patients by free vascularised fibular grafting

Yin

Zhang

Jin

et al. 2010

International Orthopaedics (SICOT)

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The purpose of this study was to assess the outcomes of treatment of femoral head osteonecrosis using free vascularised fibular grafting in patients with Hodgkin's disease and non-Hodgkin's lymphoma. We retrospectively reviewed seven patients (14 hips) with lymphoma who underwent free vascularised fibular grafting for osteonecrosis of the femoral head, evaluating pre-and postoperative Harris hip scores, visual analog scale (VAS) pain scores, hip range of motion and radiographs. Patients were followed up for a minimum of 1.5 years (mean, 3.3 years). All these patients exhibited good recovery without severe lifethreatening complications. The mean Harris hip score improved from 69 to 88, while average VAS pain score decreased from 54 to 18. At the latest follow-up, we found improvement or unchanged radiographs in all three hips with initial Steinberg stage II osteonecrosis and in nine of 11 hips with stage III or IV osteonecrosis. No hips failed treatment and underwent total hip arthroplasty. The clinical data demonstrated that free vascularised fibular grafting can slow or even halt progression of necrosis, and improve the function of the hip and quality of life in lymphoma patients.

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Morphology, dynamic mechanical, and electrical properties of bio‐based poly(trimethylene terephthalate) blends, part 1: Poly(trimethylene terephthalate)/poly(ether esteramide)/polyethylene glycol 400 bis(2‐ethylhexanoate) blends

Kobayashi

Wood

Blackman

et al. 2011

J of Applied Polymer Sci

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Bio-based PTT and PTT blends with PEEA of two different ion contents (275 ppm Na and 3515 ppm Na) and PEG 400 bis (2-ethylhexanoate) were prepared by melt processing. The blends were characterized by differential scanning calorimetry, dynamic mechanical analysis, transmission electron microscopy, and atomic force microscopy. Electro-static performance was also investigated for those PTT blends since PEEA is known as an ion conductive polymer. Here we confirmed that PEG 400 bis (2-ethylhexanoate) improves the static decay performance of PTT/PEEA blends. DMA strongly suggests that PEG 400 bis (2-ethylhexanoate) and PEEA are miscible pairs, and PEG 400 bis (2-ethylhexanoate) selectively goes into the PEEA phase rather than the PTT phase, which lowers the T g of PEEA. Besides topographic analysis of morphology and phase separation, tunneling atomic force microscopy was also applied to see if we can observe the surface directly for the static dissipative material.

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Long-term Followup of Vascularized Fibular Grafting for Femoral Head Necrosis

Cited by 105 publications

References 33 publications

The Vascularized Fibular Graft in Precollapse Osteonecrosis: Is Long-term Hip Preservation Possible?

The Vascularized Fibular Graft in Precollapse Osteonecrosis: Is Long-term Hip Preservation Possible?

Treatment of osteonecrosis of the femoral head in lymphoma patients by free vascularised fibular grafting

Morphology, dynamic mechanical, and electrical properties of bio‐based poly(trimethylene terephthalate) blends, part 1: Poly(trimethylene terephthalate)/poly(ether esteramide)/polyethylene glycol 400 bis(2‐ethylhexanoate) blends

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