Strut Allograft For Osteonecrosis of the Femoral Head

To analyze the clinical outcome of core decompression and strut allografting in the treatment of osteonecrosis of the femoral head. Twenty-six patients (29 hips) with osteonecrosis of the femoral head were treated by core decompression and bone-grafting using strut allografts. Mean patient age at the time of operation was 39 years (range, 24-56 years). The Marcus radiographic classification was stage II in 14 hips, stage III in 9 hips, and early stage IV in 6 hips. At the mean follow-up period of 645 months (range, 36-108 months), 23 hips (79%) were rated as good or very good and the remaining 6 hips had converted to a hip arthroplasty. Radiographic progression was seen in 21% of the hips in stage II, 44% in stage III, and 33% in stage IV. However, 2 hips in stage III and 2 hips in stage IV showed improvement of the radiographic stage at the latest follow-up. Twelve (86%) of 14 hips grafted at stage II, 7 (78%) of 9 hips grafted at stage III, and 4 (67%) of 6 hips grafted at stage IV had a satisfactory result at the latest follow-up. Strut cortical allograft is a good alternative in the treatment of early-stage osteonecrosis of the femoral head. The hips with ideal placement of the cortical grafts had a better clinical outcome.

並列關鍵字

strut allograft ； osteonecrosis ； core decompression ； nonvascularized bone graft

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