Mid- to long-term results of modified non-vascularized allogeneic fibula grafting combined with core decompression and bone grafting for early femoral head necrosis

Chen, Changjun; Li, Donghai; Zhao, Xin; Chen, Liyile; Wang, Qiuru; Kang, Pengde

doi:10.1186/s13018-020-1565-3

Cited by 23 publications

(15 citation statements)

References 31 publications

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“… 190 Numerous studies have shown that a non‐vascularized fibular allograft combined with CD and bone grafting is a cost‐effective way of improving the survival rate for an early stage of ONFH, delaying disease progression, and improving the quality of patients' lives. 191 , 192 …”

Section: Glucocorticoid‐induced Osteonecrosis Animal Modelsmentioning

confidence: 99%

“…Eighty hips belonging to 50 SLE patients who underwent free vascularized fibular grafting for ONFH were followed for more than 2 years (average 4.3 years) and the hip score improved in all patients 190 . Numerous studies have shown that a non‐vascularized fibular allograft combined with CD and bone grafting is a cost‐effective way of improving the survival rate for an early stage of ONFH, delaying disease progression, and improving the quality of patients' lives 191–192 …”

Section: Glucocorticoid‐induced Osteonecrosis Animal Modelsmentioning

confidence: 99%

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Glucocorticoid‐induced osteonecrosis in systemic lupus erythematosus patients

Kaneko

Chen

Kaufman

et al. 2021

Clinical & Translational Med

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Osteonecrosis (ON) is a complex and multifactorial complication of systemic lupus erythematosus (SLE). ON is a devastating condition that causes severe pain and compromises the quality of life. The prevalence of ON in SLE patients is variable, ranging from 1.7% to 52%. However, the pathophysiology and risk factors for ON in patients with SLE have not yet been fully determined. Several mechanisms for SLE patients’ propensity to develop ON have been proposed. Glucocorticoid is a widely used therapeutic option for SLE patients and high‐dose glucocorticoid therapy in SLE patients is strongly associated with the development of ON. Although the hips and knees are the most commonly affected areas, it may be present at multiple anatomical locations. Clinically, ON often remains undetected until patients feel discomfort and pain at specific sites at which point the process of bone death is already advanced. However, strategies for prevention and options for treatment are limited. Here, we review the epidemiology, risk factors, diagnosis, and treatment options for glucocorticoid‐induced ON, with a specific focus on patients with SLE.

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Section: Glucocorticoid‐induced Osteonecrosis Animal Modelsmentioning

confidence: 99%

Section: Glucocorticoid‐induced Osteonecrosis Animal Modelsmentioning

confidence: 99%

Glucocorticoid‐induced osteonecrosis in systemic lupus erythematosus patients

Kaneko

Chen

Kaufman

et al. 2021

Clinical & Translational Med

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“…Avascular fibular grafting(AVFG) for osteonecrosis of the femoral head was used widely in the past two decades [5].The advances of this operation included smaller trauma(without vascular anastomosis and usually use the allograft),simple technology, less complications and lower expense [6].Researchers had reported the outcomes of a vascularized fibular grafting but the outcomes were various [7][8][9][10].Plenty of literature researches reported that with choosing strictly indications the AVFG might have ideal clinic outcomes as well as FVFG [11].Cheng-Ta Wu et al conducted research regarding a analysis of the necrosis of femoral head with ARCO stage Ⅱ to stage ⅢB that had underwent Non-vascularized bone grafting operation for the treatment. At the final follow-up, 29 hips in 24 patients showed 88.5% of five year survival rate and 76.9% of 12-year survival rate using conversion to THA as the end point [12].…”

Section: Introductionmentioning

confidence: 99%

A Mid- to Long-Term Results of The Avascular Fibular Grafting in ONFH With 6 to 8-Year Follow-Up

Yuan¹,

Du²,

Liu³

et al. 2020

Preprint

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Background: Free vascularized fibular grafting was reported a favorable method to prevent the collapse of the femoral head. Nevertheless, this operation is traumatic and expensive. This study analyzed the long-term outcomes of avascular fibular grafting for osteonecrosis of the femoral head(ONFH) with 6 to 8 year follow-up.Methods: From March 2009 to March 2012, 34 patients(48 hips) were diagnosed the ONFH with Association Research Circulation Osseous(ARCO) stage of Ⅱ to Ⅲb and operated with avascular fibular grafting in Jiangsu Province Hospital of traditional Chinese Medicine. We retrospectively reviewed the clinic effects of these patients and assessed the difference effects with diverse stages(ARCO) and types(China-Japan Friendship Hospital classification, CJFH) annually. The hip survival rate, Harris hip score, activity level and imaging stability were calculated. The average follow-up time was 6.7 years.Results: At the last follow-up,34 of 48 hips survived totally. Depending on the ARCO stage, The overall clinical success rate for hip preserving were 76.0% (19/25) in Ⅱ stage ,85.7%(12/14) in ⅢA stage and 33.3%(3/9) in ⅢB stage. Referring to the CJFH classification system, the hip survival rate were 100%(2/2) in M type,90.9%(10/11) in C type,77.8%(14/18) in L1 type,57.1%(8/14) in L2 type and 0%(0/3) in L3 type. The mean VAS score, HHS, and WOMAC were significantly improved at the final follow-up compared with preoperative values (p < 0.001).Conclusion: The avascular fibular grafting operation can increase the hip function and improve patients’ lives quality. It possesses vast clinical as well as practical significance, because the long-term efficacy can satisfy fundamental life requirements, especially for those early-stage and small-scale patients who suffer ONFH to avoid or put off the time of total hip arthroplasty(THA) surgery.

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“…[ 12 ] reported that autologous and allogeneic fibular grafts can attain equally good clinical outcomes and high survival rates in long-term follow-up. Plenty of literature researches reported that with choosing strictly indications the AVFG might have ideal clinic outcomes as well as FVFG [ 13 ]. Chen et al .…”

mentioning

confidence: 99%

“…Chen et al . [ 13 ] conducted research regarding a analysis of the necrosis of femoral head with Ficat II that had underwent Non-vascularized bone grafting operation for the treatment. At the final follow-up, 44 patients showed 81.8% of 7-year survival rate using conversion to THA as the end point.…”

mentioning

confidence: 99%

Mid- to long-term results of modified avascular fibular grafting for ONFH

Yuan

Liu

et al. 2021

Journal of Hip Preservation Surgery

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Free vascularized fibular grafting was reported a favorable method to prevent the collapse of the femoral head. This study analyzed the mid- to long-term outcomes of avascular fibular grafting (AVFG) for osteonecrosis of the femoral head (ONFH) with 6- to 8-year follow-up. From March 2009 to March 2012, 34 patients (48 hips) were diagnosed with ONFH operated with AVFG in Jiangsu Province Hospital of traditional Chinese Medicine. We retrospectively reviewed the clinic outcomes of these patients and evaluated the differences in outcomes by diverse stages [Association Research Circulation Osseous (ARCO)] and types [China–Japan Friendship Hospital (CJFH) classification] annually. The hip survival rate, Harris hip score (HHS), activity level and imaging stability were calculated. The average follow-up time was 6.7 years. At the last follow-up, 34 of 48 hips survived totally. According to the ARCO stage, the overall clinical success rate for hip preserving were 76.0% (19/25) in II stage, 85.7% (12/14) in IIIA stage and 33.3% (3/9) in IIIB stage. Referring to the CJFH classification system, the hip survival rate were 100% (2/2) in M type, 90.9% (10/11) in C type, 77.8% (14/18) in L1 type, 57.1% (8/14) in L2 type and 0% (0/3) in L3 type. The mean visual analog scale (VAS) score, HHS and Western Ontario McMaster Osteoarthritis index (WOMAC) were significantly improved at the final follow-up compared with pre-operative values (P < 0.001). The AVFG operation can increase the hip function and improve patients’ lives quality. The mid- to long-term efficacy can satisfy fundamental life requirements, especially for those early-stage and small-scale patients who suffer ONFH to avoid or put off the time of total hip arthroplasty surgery.

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Mid- to long-term results of modified non-vascularized allogeneic fibula grafting combined with core decompression and bone grafting for early femoral head necrosis

Cited by 23 publications

References 31 publications

Glucocorticoid‐induced osteonecrosis in systemic lupus erythematosus patients

Glucocorticoid‐induced osteonecrosis in systemic lupus erythematosus patients

A Mid- to Long-Term Results of The Avascular Fibular Grafting in ONFH With 6 to 8-Year Follow-Up

Mid- to long-term results of modified avascular fibular grafting for ONFH

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