Inverted femoral head graft versus standard core decompression in nontraumatic hip osteonecrosis at minimum 3 years follow-up
| Autor: | Osman Abdellah Mohamed, Asser A. Sallam, Mohamed A. Imam, Khaled S Salama |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Decompression Avascular necrosis Risk Assessment Severity of Illness Index Surgical methods Cohort Studies 03 medical and health sciences Femoral head Young Adult 0302 clinical medicine Sex Factors Sex factors Femur Head Necrosis medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Core decompression Retrospective Studies 030222 orthopedics Bone Transplantation business.industry Graft Survival Follow up studies Age Factors Retrospective cohort study Middle Aged medicine.disease Decompression Surgical Surgery medicine.anatomical_structure Treatment Outcome Female Hip Joint business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | Hip international : the journal of clinical and experimental research on hip pathology and therapy. 27(1) |
| ISSN: | 1724-6067 |
| Popis: | Purpose Numerous salvage surgeries were popularised to halt the progression of hip osteonecrosis (ON). We aimed to compare the clinico-radiological outcomes of inverted femoral head graft (IFHG) versus standard core decompression (SCD) in treatment of nontraumatic hip ON at pre-arthritic stage. Methods A case review was performed at a minimum 3 years follow-up of 61 patients (71 hips; mean age 32.96 (19-50) years; mean follow-up 7.86 (3-14) years; mean body mass index 28.58 (19-46); 32 males, 29 females) suffering nontraumatic hip ON at pre-arthritic stage. 38 hips underwent SCD and 33 IFHG. The outcome was assessed by changes in modified Harris Hip Score (MHHS), need for revision surgery and progression of modified Ficat-Arlet staging. Data were analysed including logistic regression and Kaplan-Meier survivorship analysis. Results 13/34 (38.2%) hips in SCD group were revised at 4.61 ± 2.61 years, while 7/33 (21.2%) in IFHG group at 8.43 ± 4.32 years (p = 0.023). MHHS was significantly higher in IFHG group at 1 and 3 years as well as at last follow-up (p = 0.014, 0.001 and 0.023 respectively). Clinical and radiological significant differences were found in survivorship analysis between both groups, in favor of IFHG. A higher clinical failure was noted among obese patients. Conclusions An IFHG technique offers a better alternative regarding postoperative clinico-radiological outcomes in nontraumatic hip ON at the pre-arthritic stage. A cautious prognosis is recommended in obese patients. |
| Databáze: | OpenAIRE |
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