Vascularized island pedicle iliac bone grafting for avascular necrosis of the femoral head.

BACKGROUND

Nontraumatic avascular necrosis of the femoral head is a common disorder causing disability of the hip joint. The methods for optimally treating this disease in active young patients are still controversial. In this study we investigated the surgical outcome of vascularized pedicle iliac bone grafting for treating nontraumatic avascular necrosis of the femoral head.

METHODS

Between 1994 and 1999, we treated 100 cases of avascular necrosis of the femoral head with vascularized pedicle iliac bone grafting. Thirty-nine hips in 33 patients were followed-up longer than 24 months. These patients included 30 men and 3 women, with an average age of 40 years. Steinberg's classification and Ohzono's types were used to categorize the diseased hips. The clinical results were evaluated using Charnley's modification of Merle d'Aubigne and Postel's numeric classification.

RESULTS

Of the 33 patients, 82% were satisfied with their decision to have vascularized pedicle iliac bone grafting for avascular necrosis of the femoral head. No serious complications arose during this study. The average operation time for vascularized pedicle iliac bone grafting was 3.5 hours for one team. The rate of conversion to replacement arthroplasty was 10.3% (4 of 39 patients).

CONCLUSION

Vascularized pedicle iliac bone grafting is a useful alternative treatment option for patients with avascular necrosis of the femoral head.