Osteonecrosis of Femoral Head: Efficacy of Core Decompression and Non Vascularised Fibular Graft
IOSR Journal of Dental and Medical Sciences
We present the results of osteonecrosis of femoral head treated by core decompression with non vascularized fibular graft. Patient and Methods: 20 patients with osteonecrosis femoral head treated between 2012 and 2015 were included in the study.We performed core decompression and non vascular fibular grafting. All patients were evaluated clinically and radiologically and were belonging to pre collapsing stage (I and II) according to Ficat and Arlet classification. Outcome was assessed with
... s hip score. Results: We achieved good subjective and functional outcome in patients. The results were considered as a success if there was no progression of disease, confirmed radiologically,or no subsequent surgeries were required. In our series, 14 patients had excellent outcome and all of them returned to their previous activity. Progressive pain and progression of collapse was seen in 5 patients and they eventually ended up in total hip replacement. 1 patient expired during the study period due to medical co morbidities. The mean Harris hip score was 72.3 at the end of follow up period. Conclusion: Management of osteonecrosis of femoral head with non vascularized fibular graft proved to be an excellent treatment modality compared to other non operative methods. The procedure provides decompression of the avascular lesion and removal of the necrotic bone in order to interrupt the cycle of ischemia and interosseous hypertension. However long follow-up period is absolutely necessary for accessing the long term outcome.