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International Orthopaedics
Published in: International Orthopaedics 10/2018

01-10-2018 | Original Paper

Muscle pedicle bone grafting using the anterior one-third of the gluteus medius attached to the greater trochanter for treatment of Association Research Circulation Osseous stage II osteonecrosis of the femoral head

Published in: International Orthopaedics | Issue 10/2018

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Abstract

Purpose

The aim of this study was to evaluate the effectiveness of our technique on further collapse of the femoral head in Association Research Circulation Osseous (ARCO) stage II, patient’s functional improvements, and analyze the survival rate of the affected hip.

Methods

Between June 2007 and March 2015, 24 hips diagnosed with osteonecrosis of the femoral head (ONFH) were treated with our muscle pedicle bone grafting (MPBG) technique using anterior one-third of gluteus medius attached to the greater trochanter. The group was consisted of 15 men and eight women, mean age of 36 years at the time of surgery. Mean follow-up was 6.2 years.

Results

Four hips showed regeneration, 11 hips showed no progression, and nine hips showed slight extent of the lesion. But during the follow-up, three hips underwent total hip arthroplasty at the mean follow-up of 5.8 years after the surgery. The survival rate at the last follow-up was approximately 87.5%. Excluding the three failed cases, the mean total Harris hip score was improved from 57.2 to 82.3 points (p < 0.05). We had no case of complications such as limping, numbness, wound infection, heterotopic ossification, nor intra- and post-operative fracture.

Conclusion

We showed 87.5% of survival rate by average of 6.2-year follow-up, maximum of 10.1 years. And compared to other reports, our technique showed relatively good results. In the short term, our modified MPBG technique seems to be effective in ARCO stage II ONFH. We, therefore, suggest this technique as one of the promising treatments of choices for patients with ARCO stage II ONFH.
Literature
1.
Coventry MB, Beckenbaugh RD, Nolan DR, Ilstrup DM (1974) 2,012 total hip arthroplasties: a study of postoperative course and early complications. J Bone Joint Surg Am 56:273–284CrossRef
2.
Herndon JH, Aufranc OE (1972) A vascular necrosis of the femoral head in the adult: a review of its incidence in a variety of conditions. Clin Orthop Relat Res 86:43–62CrossRef
3.
Mankin HJ (1992) Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 326:1473–1479CrossRef
4.
Baksi DP, Pal AK, Baksi DD (2009) Long-term results of decompression and muscle-pedicle bone grafting for osteonecrosis of the femoral head. Int Orthop 33(1):41–47CrossRef
5.
Aldridge JM 3rd, Urbaniak JR (2007) A vascular necrosis of the femoral head: role of vascularized bone grafts. Orthop Clin North Am 38(1):13–22CrossRef
6.
Brinker MR, Rosenberg AG, Kull L, Galante JO (1994) Primary total hip arthroplasty using noncemented porous coated femoral components in patients with osteonecrosis of the femoral head. J Arthroplast 9:457–468CrossRef
7.
Krackow KA, Mont MA, Maar DC (1993) Limited femoral endoprosthesis for avascular necrosis of the femoral head. Orthop Rev 22:457–463PubMed
8.
Saito S, Saito M, Nishina T, Ohzono K, Ono K (1989) Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis. Clin Orthop Relat Res 244:198–207
9.
Stauffer RN (1982) Ten-year follow-up study of total hip replacement. J Bone Joint Surg Am 64:983–990CrossRef
10.
Aldridge JM III, Urbaniak JR (2004) Bone grafting for osteonecrosis of the femoral head. Semin Arthroplasty 15:151–160CrossRef
11.
Fairbank AC, Bhatia D, Jinnah RH, Hungerford DS (1995) Long-term results of core decompression for ischemic necrosis of the femoral head. J Bone Joint Surg (Br) 77:42–49CrossRef
12.
Rosenwasser MP, Garino JP, Kiernan HA, Michelsen CB (1994) Long term followup of thorough debridement and cancellous bone grafting of the femoral head for avascular necrosis. Clin Orthop Relat Res 306:17–27
13.
Wang BL, Sun W, Shi ZC, Zhang NF, Yue DB, Guo WS, Shi SH, Li ZR (2010) Treatment of nontraumatic osteonecrosis of the femoral head using bone impaction grafting through a femoral neck window. Int Orthop 34(5):635–639CrossRef
14.
Forgon M, Montsko P (1996) Muscle-pedicle grafts or muscle-pedicle-bone grafts in the treatment of avascular necrotic femoral heads. Arch Orthop Trauma Surg 115(3–4):223–226CrossRef
15.
ARCO (Association Research Circulation Osseous) (1992) Committee on terminology and classification. ARCO News 4:41–46
16.
Kerboul M, Thomine J, Postel M, D’Aubigne RM (1974) The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. J Bone Joint Surg (Br) 56:291–296CrossRef
17.
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end result study using a new method of result evaluation. J Bone Joint Surg (Am) 51:737–755CrossRef
18.
Hartley WT, McAuley JP, Culpepper WJ, Engh CA Jr, Engh CA Sr (2000) Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. J Bone Joint Surg Am 82:1408–1413CrossRef
19.
Brunelli G (1991) Free microvascular fibular transfer for idiopathic femoral head necrosis: long-term follow-up. J Reconstr Microsurg 7:285–295CrossRef
20.
Baksi DP (1991) Treatment of osteonecrosis of the femoral head by drilling and muscle-pedicle bone grafting. J Bone Joint Surg (Br) 73:241–245CrossRef
21.
Iwato H, Torii S, Hasegqwa Y, Itoh H, Mizuno M, Genda E, Kataoka Y (1993) Indications and results of vascularized pedicle iliac bone graft in avascular necrosis of the femoral head. Clin Orthop Relat Res 295:281–288
22.
Urbaniak JR, Coogan PG, Gunneson EB, Nunley JA (1994) Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting: a long-term follow-up study of one hundred and three hips. J Bone Joint Surg Am 77:681–694CrossRef
23.
Ishizuka M, Sofue M, Dohmae Y, Endo N, Takahashi H (1997) Vascularized iliac bone graft for avascular necrosis of the femoral head. Clin Orthop Relat Res 337:140–148CrossRef
24.
Sotereanos DG, Plakseychuk AY, Rubash HE (1997) Free vascularized fibular grafting for treatment of osteonecrosis of the femoral head. Clin Orthop Relat Res 344:243–256CrossRef
Metadata
Title
Muscle pedicle bone grafting using the anterior one-third of the gluteus medius attached to the greater trochanter for treatment of Association Research Circulation Osseous stage II osteonecrosis of the femoral head
Publication date
01-10-2018
Published in
International Orthopaedics / Issue 10/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3839-5

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