Mehmet Bekir ÜNAL, CENGİZ EREN CANSÜ, Fatih PARMAKSIZOĞLU, Hakan ÇİFT, Serkan GÜRCAN

Treatment of osteonecrosis of the femoral head with free vascularized Şbular grafting: Results of 7.6-year follow-up

Objectives: The aim of this study was to determine long term follow up of the patients who had femoralhead osteonecrosis and had been treated with free vascularizedŞbular grafting.Patients and methods: We retrospectively reviewed 28 hips of 21 patients who had undergone freevascularizedŞbular grafting for the treatment of osteonecrosis of femoral head. There were 16 male and5 female patients. The mean age of the patients at the time of surgery was 30.7 years (between 15 and 53years). The mean follow-up time was 7.6 years (between 5 years and 9.2 years).Results: During follow-up, one patient died because of leukemia, and one patient was lost. The remaining26 hips of 19 patients were evaluated. According to the Ficat classiŞcation, at the time of surgery, 17 hipswere in grade 2 and 9 hips were in grade 3. The post-operative Harris hip scores in grade II disease wereexcellent in 12 patients, good in 3 patients, and fair in 1 patient. In grade III disease, 1 patient wasexcellent, 5 patients were good, and 1 patient was fair. There was a signiŞcant increase in HHS scores(61± 9.7 vs 84 ± 17.8, p < 0.001).Conclusion: Free vascularizedŞbular grafting yields extremely good results, particularly in pre-collapsestages of disease in young patients. The operation time does not mark increased if the surgical team is"familiar" with the procedure, and the residual Şbular defect of the donor site does not impair thefunctions of daily living.Level of Evidence: Level IV, Therapeutic study.© 2016 Publishing services by Elsevier B.V. on behalf of Turkish Association of Orthopaedics andTraumatology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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