Fontecha Cesar G, Roca Isabel, Barber Ignasi, Menendez Mariano E, Collado Diego, Mascarenhas Vasco V, Barrera-Ochoa Sergio, Soldado Francisco
Pediatric Orthopaedic Unit, Hospital Universitari Vall D'hebron, Barcelona, Spain.
Nuclear Medicine Department, Hospital Universitari Vall D'hebron, Barcelona, Spain.
Microsurgery. 2016 Oct;36(7):573-577. doi: 10.1002/micr.22452. Epub 2015 Jul 27.
To evaluate femoral head bone viability following free vascularized fibular grafting (FVFG) for osteonecrosis using SPECT/CT imaging.
Ten hips (9 patients) with osteonecrosis of the femoral head (ONFH) undergoing FVFG were prospectively enrolled. Four cases showed ARCO stage II, while six showed ARCO stage III. The mean age at surgery was 15.7 years (range, 13-22 years). Hip Harris Score (HHS) was measured pre- and post-operative. Bone scintigraphy with SPECT/CT was performed at 2 weeks and 6 months following surgery.
Mean follow-up was 4.0 years (range, 2-5.9 years). Mean HHS increased from 37.2 to 92.3. SPECT/CT findings revealed a progressive increase of femoral head uptake in all cases, suggesting subchondral graft bone viability. No progressive deformation of the femoral head was evidenced in radiographic evaluation at final follow-up.
This study demonstrates FVFG's capacity for revitalizing femoral head subchondral bone grafting in patients with ONFH, surgically treated following Urbaniak's technique. © 2015 Wiley Periodicals, Inc. Microsurgery 36:573-577, 2016.
使用SPECT/CT成像评估游离血管化腓骨移植（FVFG）治疗股骨头坏死术后股骨头骨的存活情况。
前瞻性纳入10例（9例患者）接受FVFG治疗的股骨头坏死（ONFH）患者。4例为ARCO II期，6例为ARCO III期。手术时的平均年龄为15.7岁（范围13 - 22岁）。术前和术后测量髋关节Harris评分（HHS）。术后2周和6个月进行SPECT/CT骨显像。
平均随访4.0年（范围2 - 5.9年）。平均HHS从37.2提高到92.3。SPECT/CT结果显示所有病例股骨头摄取逐渐增加，提示软骨下移植骨存活。末次随访时的影像学评估未发现股骨头有进行性变形。
本研究表明，采用Urbaniak技术手术治疗的ONFH患者，FVFG能够使股骨头软骨下骨移植恢复活力。©2015威利期刊公司。显微外科学36:573 - 577，2016年。
