Sartorius muscle-pedicle bone graft for osteonecrosis of the femoral head

Chen, Xiantao; Tan, Xiaohong; Gao, Shu-tu; Xiao-dong, Zhang; Li, Jianming; Liu, Youwen

doi:10.1007/s00264-015-2921-5

Cited by 16 publications

(19 citation statements)

References 14 publications

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“…The clinical studies included one randomized control trial (RCT) [21], two case-control studies [22, 23], and 13 case series studies [24–36]. The length of follow-up for the RCTs was 12 months.…”

Section: Resultsmentioning

confidence: 99%

Vascularized pedicle iliac bone grafts as a hip-preserving surgery for femur head necrosis: a systematic review

Yang¹,

Wei²,

Chen³

et al. 2019

J Orthop Surg Res

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Background Osteonecrosis of the femoral head was gradually concerned as a global disease for its progression to collapse of the femoral head, ultimately causing the arthritic change. Due to the high incidence of this disease in young people, arthroplasty tends to be suspected for its uncertain long-term efficiency. Vascularized pedicle iliac bone grafts, as a hip-preserving surgery, were regarded as an effective option in hip-preserving protocol since the 1970s. Nevertheless, there exist no unified standards widely agreed as the optimal operative program since the lack and heterogeneity of related studies. Thus, we execute this systematic review to synthesize and analyze existing studies, and further suggest a direction of future researches. Methods Data were collected by searching electronic database (PubMed, Embase, and Cochrane Library) and including the eligible studies of all types of clinical researches except case report. Through our extraction and synthesis of included study results in respect of clinical evaluation (rating scales), radiographic evaluation, joint survival rate, viability of implanted flap, and complications by transform varied assessment method into a unified standard, we qualitatively analyze and discuss the efficacy of VPIBG according to the quality of individual study and the heterogeneity across the included studies. Results Our systematic review includes 1 RCT, 2 case-control studies, and 13 case series studies, resulting in a significant improvement of postoperative scores. Minority of hips progressed for joint replacement. Some researches suggested a high collapse rate in the collapsed femoral head before the operation. Compared with some other hip-preserving surgeries, the complications of VPIBG are relatively slight and barely affect clinical efficiency. Conclusions A better clinic response was obtained after this treatment, especially in femoral heads before the appearance of a crescent sign. The fixation of the implanted iliac bone flap increases the clinical effect. The majority of complications were slight and rarely affected clinical efficacy. Electronic supplementary material The online version of this article (10.1186/s13018-019-1262-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Vascularized pedicle iliac bone grafts as a hip-preserving surgery for femur head necrosis: a systematic review

Yang¹,

Wei²,

Chen³

et al. 2019

J Orthop Surg Res

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“…The score used for the evaluation of preoperative and postoperative pain did not present statistically significant alterations after six months, which indicates that the decompression treatment improves the early pain symptomatology, but does not alter the disease prognosis. This has been a challenge for hip surgeons, who have used new techniques associated with core decompression, such as the use of vascularized or non vascularized grafts, 26 , 27 , 28 stem cell injection, 29 shock waves, and anticoagulant drugs. 30 Moreover, various techniques have been described using different types of drills and number of drillings.…”

Section: Discussionmentioning

confidence: 99%

What is the role of core decompression in the early stages of osteonecrosis of the femoral head? Evaluation of the surgical result by functional score and radiological follow-up

Miyahara

Rosa

Hirata

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectivesThis study is aimed at evaluating whether core decompression of the femoral head in the early stages of femoral head osteonecrosis improves patients’ subjective perception of pain and avoids the progression of the disease to a femoral head collapse and a final indication of total hip arthroplasty.MethodsEighteen patients (30 hips) in the early stages of the disease (Ficat and Arlet 1 and 2A) were evaluated through clinical, radiological, risk factor maintenance, and by the functional Merle D’Aubigné, and Postel score before and after core decompression of the femoral head.ResultsThere was an improvement of symptoms up to the sixth month in 83.3% of the hips evaluated through the Merle D’Aubigné and Postel score. However, 73.3% of the cases evolved with femoral head collapse, and in 50%, total hip arthroplasty was indicated regardless of whether or not the risk factors were maintained.ConclusionsCore decompression of the femoral head improves patients’ pain early in the initial stages of the pathology. However, it does not alter the prognosis and the ultimate indication of total hip arthroplasty in the final stages of the disease.

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“…It was idiopathic in 8 patients (12 hips). The Association Research Circulation Osseous (ARCO) classification was the basis on which we diagnosed, analyzed, and classified ONFH [1]. The femoral heads were staged as IIB (n = 15), IIC (n = 19), IIIA (n = 34), IIIB (n = 4), and IIIC (n = 1).…”

Section: Methodsmentioning

confidence: 99%

“…Osteonecrosis of the femoral head (ONFH) is a progressive, destructive disease of the hip joint caused by factors such as hormones, alcohol abuse, and trauma [1]. These factors can directly or indirectly destroy the blood circulation of the femoral head, in which case the survival of bone cells and bone marrow tissue may be affected [2,3].…”

Section: Introductionmentioning

confidence: 99%

Single approach to double-channel core decompression and bone grafting with structural bone support for treating osteonecrosis of the femoral head in different stages

et al. 2020

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Background: We created a novel method-single approach to double-channel core decompression and bone grafting with structural bone support (SDBS)-to treat early-stage osteonecrosis of the femoral head (ONFH) by improving the Phemister technique. This study aimed to evaluate the results of SDBS for early-stage ONFH. Methods: Altogether, 53 patients (73 hips) were treated using SDBS during 2016-2018. Bilateral (20 patients) and unilateral (33 patients = 18 left hips, 15 right hips) ONFH was diagnosed. According to the Association Research Circulation Osseous classification stages, the femoral heads were staged as IIB (n = 15), IIC (n = 19), IIIA (n = 34), IIIB (n = 4), and IIIC (n = 1). The Harris hip score was used to evaluate the hips' clinical function, computed tomography to evaluate subchondral fractures, and plain radiography to assess the extent of femoral head collapse. Results: The average follow-up was 20.71 ± 6.65 months (6-36 months). At the patients' last follow-up, 4 hips were found to require arthroplasty. Thus, the overall femoral head survival rate was 94.52% (69/73). Also, the overall Harris score (84.44 ± 14.57) was significantly higher than that preoperatively (77.67 ± 14.37) (P = 0.000). The combined excellent and good rate (76.71%) was significantly higher than that preoperatively (38.36%) (P = 0.000). Imaging showed that 16 femoral heads had some ONFH progression. The average length of stay was 6.15 ± 0.86 days. The average incision measured 2.69 ± 0.30 cm. Intraoperative blood loss was 61.20 ± 4.81 ml. There were no complications during or after the operation. Conclusion: SDBS is an effective method for treating early-stage ONFH. It is a hip-preserving surgical approach to slow/prevent ONFH progression.

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Sartorius muscle-pedicle bone graft for osteonecrosis of the femoral head

Abstract: Sartorius muscle-pedicle bone graft significantly promotes repair of osteonecrosis of the femoral head, improves the Harris score of the hip joints, with good clinical efficacy. It effectively improves the survival rate of femoral head, delaying or preventing artificial hip replacement.

Cited by 16 publications

References 14 publications

Vascularized pedicle iliac bone grafts as a hip-preserving surgery for femur head necrosis: a systematic review

Vascularized pedicle iliac bone grafts as a hip-preserving surgery for femur head necrosis: a systematic review

What is the role of core decompression in the early stages of osteonecrosis of the femoral head? Evaluation of the surgical result by functional score and radiological follow-up

Single approach to double-channel core decompression and bone grafting with structural bone support for treating osteonecrosis of the femoral head in different stages

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