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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2021 | Osteonecrosis of the Femoral Head | Research article

Long-term survival and clinical outcomes of non-vascularized autologous and allogeneic fibular grafts are comparable for treating osteonecrosis of the femoral head

Authors: Ke Jie, Wenjun Feng, Feilong Li, Keliang Wu, Jinlun Chen, Guanming Zhou, Huiliang Zeng, Yirong Zeng

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2021

Abstract

Background

Osteonecrosis of the femoral head (ONFH) is a disabling disease, which often involves young patients. Recently, various hip-preserving surgeries were recommended to delay total hip arthroplasty (THA).

Questions/purposes

This study aimed to compare clinical outcomes and survival rate in the long-term follow-up between core decompression combined with a non-vascularized autologous fibular graft (group A) and an allogeneic fibular graft (group B) for the treatment of ONFH.

Patients and methods

We retrospectively evaluated 117 patients (153 hips) with ONFH (Association Research Circulation Osseous [ARCO] stages IIa to IIIc) who underwent the abovementioned hip-preserving surgeries between January 2003 and June 2012. The mean (range) follow-up times (years) were 12.9 (7–16) and 9.3 (6–16) in groups A and B, respectively. Clinical outcomes were assessed using the Harris Hip Score (HHS), visual analog scale (VAS) score, and forgotten joint score (FJS). A survival analysis was performed using the Kaplan-Meier method. The end point was THA.

Results

Groups A and B showed postoperative improvements, respectively, in HHS from 65 ± 7.2 to 80.3 ± 14.5 and from 66 ± 5.9 to 82.4 ± 13.6 (p < 0.05), and in VAS score from 6.3 ± 1.1 to 2.3 ± 1.6 and from 6.1 ± 1 to 2.2 ± 2.2 (p < 0.05). However, no significant differences in the HHS, VAS score, and hip FJS at the last follow-up (p > 0.05) and 15-year survival rate (84.1% and 86%, respectively, p > 0.05) were found between groups A and B.

Conclusions

Autologous and allogeneic fibular grafts can attain equally good clinical outcomes and high survival rates in long-term follow-up, and thus can greatly delay THA owing to good bone osseointegration and sufficient mechanical support. Notably, the ratio of failure will increase when patients were more than 37 years old.

Level of evidence

Level III, therapeutic study

Available only for authorised users

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Title: Long-term survival and clinical outcomes of non-vascularized autologous and allogeneic fibular grafts are comparable for treating osteonecrosis of the femoral head
Authors: Ke Jie
Wenjun Feng
Feilong Li
Keliang Wu
Jinlun Chen
Guanming Zhou
Huiliang Zeng
Yirong Zeng
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Osteonecrosis of the Femoral Head
Core Decompression
Hip-TEP
Hip-TEP
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2021
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-021-02246-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term survival and clinical outcomes of non-vascularized autologous and allogeneic fibular grafts are comparable for treating osteonecrosis of the femoral head

Abstract

Background

Questions/purposes

Patients and methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Patients and methods

Results

Conclusions

Level of evidence

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