The treatment of avascular necrosis of the femoral head with vascularized fibular grafting: a report of three cases

Kömürcü M, Erler K, Ozdemir S, Bek D, Altinmakas M

Acta Orthop Traumatol Turc. 2005;39(5):449-54.

Abstract

Three male patients aged 21, 21, and 24 years were treated with vascularized fibula grafting for avascular necrosis of the femoral head. The disease was found idiopathic in two cases, while one patient was on steroid therapy. According to the Pennsylvania University Staging System, preoperative radiologic stages were 2a, 2b, and 2c. At the end of a mean follow-up period of 31 months (range 30 to 32 months), there was no progression in two patients, whereas the patient with stage 2c disease was found as stage 3b. The mean Harris hip score increased from preoperative 54 (range 52 to 58) to postoperative 93.3 (range 86 to 100). Vascularized fibula grafting may be an alternative method for early stages of avascular necrosis of the femoral head especially in young patients, because it prevents subchondral collapse, delays total hip arthroplasty, and offers a high success rate.