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- Title
Outcomes of total hip arthroplasty after failed free vascularized fibular grafting for osteonecrosis of the femoral head.
- Authors
Kim, Yoon-Vin; Song, Joo-Hyoun; Lim, Young-Wook; Jo, Woo-Lam; Lee, Se-Won; Shin, Wu-Seok; Lee, Kee-Haeng
- Abstract
Purpose: Total hip arthroplasty (THA) after vascularized fibular grafting (VFG) is technically demanding with poorer outcomes compared to primary THA in patients with osteonecrosis of the femoral head (ONFH). The purpose of this study was to compare the outcomes of THA after VFG after removal of the graft with that of primary THA. Methods: ONFH patients treated by VFG at a single institution were studied retrospectively. THAs after VFG performed by single arthroplasty surgeon with a single type of THA prosthesis were enrolled in the study. A control cohort of patients was created by 1:1 matching with the THA after VFG cohort according to age, gender, and American Society of Anesthesiology (ASA) score from ONFH patients treated by primary THA. Early and long-term outcomes were compared between the two groups. Results: A total of 24 hips were included in the THA after VFG group and compared with 24 primary THA hips. No significant difference was noted in stem position. The THA after VFG group had increased blood loss and longer duration of operation time. There were two cases of intraoperative femur fractures in the THA after VFG group. The femoral stem of both groups were stable, with no cases of revision, and similar HHS scores at the last follow-up. Conclusion: THA after VFG may have similar short to midterm outcomes with primary THA after removal of the residual abutting bone graft and correct positioning of the femoral stem.
- Subjects
TOTAL hip replacement; OSTEONECROSIS; ANESTHESIOLOGY; FEMUR head; RETROSPECTIVE studies; ARTHROPLASTY; TREATMENT effectiveness; COMPARATIVE studies; TRANSPLANTATION of organs, tissues, etc.; LONGITUDINAL method
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2023, Vol 33, Issue 6, p2347
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-022-03440-7