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Local Cancellous Bone Grafting for Osteonecrosis of the Femoral Head

Department of Orthopaedics, Chang Gung Memorial Hospital, Taoyuan, Department of Medicine, School of Medicine, Chang Gung University, Taoyuan

Chi-Chien Hu, MD

Department of Orthopaedics, Chang Gung Memorial Hospital, Taoyuan

Dave W. Chen, MD

Department of Orthopaedics, Chang Gung Memorial Hospital, Taoyuan

Steve W. N. Ueng, MD

Department of Medicine, School of Medicine, Chang Gung University, Taoyuan

Chun-Hsiung Shih, MD

Department of Orthopaedics, Chang Gung Memorial Hospital, Taoyuan, Department of Orthopaedics, Chun-Shan Hospital, Taipei

Mel S. Lee, MD, PhD

Department of Orthopaedics, Chang Gung Memorial Hospital, Taoyuan, Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, bone{at}doctor.com

Objective. This study reports a novel local bone graft technique for the treatment of osteonecrosis of femoral head (ONFH). Materials and methods. From 1998 to 2005, a procedure using local bone grafting was performed for the treatment of ONFH in 11 patients. The local bone grafts were obtained from the intertrochanteric region and then impacted into the necrotic lesion. A wire coil was inserted into the remaining space after the grafting. Results. At a mean follow-up of 61 months (range, 30 to 103 months), all 5 ARCO stage IIC hips survived but 3 of the 6 ARCO stage IIIA hips failed. The overall clinical success rate was 73%. Conclusions. This study demonstrates that local cancellous bone grafting combined with a space-filling device implanted into the ONFH is a promising procedure and the wire coil showed no interference to the remodeling of the femoral head after grafting.

Key Words: osteonecrosis • bone graft • femoral head

This version was published on March 1, 2009

Surgical Innovation, Vol. 16, No. 1, 63-67 (2009)
DOI: 10.1177/1553350608330398


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