Operative technique and results of core decompression and filling with bone grafts in the treatment of osteonecrosis of femoral head
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2010, Vol 12, Issue 6
Abstract
SummaryIntroduction: The aim of this paper is to present the operative technique and results of core decompression and clearing of a necrotic zone in the femoral head followed by filling the defect with impacted autologous or synthetic bone grafts. This procedure allows for mechanical prevention of further collapse of the femoral head and loss of its spherical shape. It also creates conditions for the incorporation of the biological graft or synthetic bone.Materials and methods: A series of 63 patients (72 hips) were treated for aseptic osteonecrosis of the femoral head between 1996 and 2009. This group comprised 42 men and 21 women aged 19 to 60 years (average age: 35 years). Radiographic staging of necrosis was based on the ARCO (Association Research Circulation Osseous) classification. All patients were treated with core decompression followed by filling the bone defect with autologous or synthetic (Wright ProDense) bone grafts.Results: Average follow-up was 5 years (from 1 to 12 years). After one year of follow-up, pain relief with preservation of a spherical femoral head was obtained in 45 hips (63%). Sixteen hips (22%) had significant limitation of the range of motion that, however, did not exceed preoperative values, with no significant pain during walking, and loss of the spherical shape of the femoral head on radiographs.Conclusions: Filling the defect with morsellized or synthetic bone grafts followed by graft impaction creates mechanical and biological conditions for graft incorporation. Where collapse has not occurred during the first six post-operative months, a good and lasting result can be expected.
Authors and Affiliations
Andrzej Bednarek , Jacek Gągała , Łukasz Kozak Department of Orthopaedics and Traumatology, Medical University of Lublin, Poland
Keywords
Related Articles
- EP ID EP57062
- DOI -
- Views 88
- Downloads 0
Złamanie implantu typu OSS jako powikłanie endoprotezoplastyki poresekcyjnej wykonanej z powodu urazu wysokoenergtycznego okolicy stawu kolanowego. Studium przypadku
Zaopatrzenie wysokoenergetycznych złamań części dalszej kości udowej stanowi znaczne wyzwanie. Rozwój metod osteosyntezy umożliwił skuteczne leczenie tego typu złamań, jednak rozległe ubytki kostne powstałe podczas urazu...
Outcomes of Total Knee Arthroplasty in Patients with Bleeding Disorders
Background. Advanced haemophilic arthropathy is a possible complication in patients with congenital bleeding disorders. This study aimed to assess treatment outcomes after primary total knee arthroplasty in this group o...
Back pain in lower and upper secondary school pupils living in urban areas of Poland. The case of Poznań
OBJECTIVES: To determine the lifetime prevalence and characteristics of non-specific back pain (low back pain, upper back pain) and neck pain in adolescents living in urban areas of Poland. We also studied the impact of...
Klasyfikacje radiologiczne Catteralla i Herringa w ocenie choroby Perthesa – zgodność i powtarzalność oceny
Wstęp. Celem pracy jest porównanie poziomu zgodności i powtarzalności kwalifikacji zmian chorobowych według klasyfikacji Catteralla i Herringa w trakcie leczenia choroby Perthesa.Materiał i metody. Materiał obejmował rad...
Evaluation of effectiveness of osteoporosis treatment in patient with pachydermoperiostosis according to densitometric findings
This study presents the outcome of osteoporosis treatment in a 29-year-old male patient with full-blown Touraine-Solente-Gole syndrome. His first DXA densitometry of the proximal femur demonstrated severe osteoporosis (B...