Investigating Clinical Failure of Bone Grafting through a Window at the Femoral Head Neck Junction Surgery for the Treatment of Osteonecrosis of the Femoral Head

Autor: Dingyan Zhao, Fuqiang Gao, Zuo Wei, Wei Sun, Yangming Su, Zirong Li
Rok vydání: 2016
Předmět:
Male
Etiology
medicine.medical_treatment
lcsh:Medicine
Bone grafting
Pathology and Laboratory Medicine
Treatment failure
0302 clinical medicine
Femur Head Necrosis
Medicine and Health Sciences
Medicine
Postoperative Period
Treatment Failure
030212 general & internal medicine
Clinical failure
lcsh:Science
Musculoskeletal System
Aged
80 and over
030222 orthopedics
Bone Transplantation
Multidisciplinary
Femur Neck
Graft Survival
Follow up studies
Femur Head
Middle Aged
medicine.anatomical_structure
Vertebrates
Frogs
Female
Radiology
Anatomy
Research Article
Adult
medicine.medical_specialty
Surgical and Invasive Medical Procedures
Pelvis
Amphibians
Necrosis
03 medical and health sciences
Femoral head
Signs and Symptoms
Musculoskeletal System Procedures
Diagnostic Medicine
Animals
Humans
Aged
Retrospective Studies
Hip
Joint Replacement Surgery
business.industry
lcsh:R
Organisms
Biology and Life Sciences
Health Risk Analysis
Correction
Surgery
Health Care
Lesions
lcsh:Q
Graft survival
Primary Graft Dysfunction
business
Follow-Up Studies
Zdroj: PLoS ONE
PLoS ONE, Vol 11, Iss 6, p e0156903 (2016)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0156903
Popis: Aims This study aimed to analyze the clinical factors related to the failure of bone grafting through a window at the femoral head-neck junction. Methods In total, 119 patients (158 hips) underwent bone grafting for treatment of avascular necrosis of the femoral head. The patients were classified by their ARCO staging and CJFH classification. All patients were clinically and radiographically followed up every three months during the first year and every six months in the following year. The clinical follow-up comprised determination of pre- and postoperative Harris hip scores, while serial AP, frog lateral radiographs, and CT scan were used for the radiographic follow-up. Results The clinical failure of bone grafting was observed in 40 patients. The clinical failure rates in patients belonging to ARCO stage II period, IIIa, and III (b + c) were 25.9%, 16.2%, and 61.5%, respectively, while those in patients belonging to (C + M + L1) type and L2, L3 type disease groups were 1.7%, 38.9%, and 39%, respectively. The clinical failure rates in patients aged below 40 and those aged 40 and over were 20.5% and 39.0%, respectively (all P < 0.05). Conclusion Disease type, disease stage, and patient age are risk factors for failure of bone graft surgery. Patients belonging to ARCO stage II and IIIa showed a good overall response rate, while patients belonging to ARCO stage IIIb and IIIc and those with necrotic lesions involving the lateral pillar (L2 and L3 type) showed high surgical failure rates.
Databáze: OpenAIRE
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