Hoại tử xương của các tài khoản đầu đùi cho như nhiều như 18% của tổng số hip arthroplasty Biểu diễn tại các nước phương Tây. Tuổi trẻ của các bệnh nhân có khả năng bị ảnh hưởng và kết quả nghèo có lãi suất gây ra trong năm Phương thức Xử lý thay thế. Extracapsular vị trí của một fibular ghép mạch máu | Revascularization of the Femoral Head in Osteonecrosis James R. Urbaniak MD and Edward J. Harvey MD FRCSC Abstract Osteonecrosis of the femoral head accounts for as many as 18 of total hip arthroplasties performed in western countries. The young age of affected patients and the potentially poor outcome have sparked an interest in alternative treatment modalities. Extracapsular placement of a vascularized fibular graft in the subchondral region of the femoral head has shown great promise as a treatment option. The authors have used this procedure in the treatment of 646 symptomatic hips of all grades of osteonecrosis with a follow-up of 1 to 17 years. The resultant 10-year survival rate of greater than 80 suggests that this procedure may be preferable to total hip arthroplasty for the young patient with osteonecrosis of the femoral head. J Am Acad Orthop Surg 1998 6 44-54 Osteonecrosis of the femoral head in the young patient and the resultant debilitation affecting both daily activities and ability to meet occupational demands is a growing concern. It has been estimated that 5 to 18 of total hip arthroplasties in western countries are performed for the primary diagnosis of The incidence in developing countries with a high prevalence of sickle cell trait is higher radiographic findings of osteonecrosis are seen in up to 50 of patients with sickle cell A large proportion of patients with osteonecrosis are less than 50 years of age. Over the past 17 years the average age of the 550 patients 822 hips treated at our institution for osteonecrosis was 33 years. Many options for the treatment of osteonecrosis have been reported. However the results have been less than ideal. No salvage method has been clearly shown to reliably halt the radiographic or clinical progression of osteonecrosis. Continuing concerns about cement disease particulate matter and stress-shielding changes in the femur make total hip arthroplasty a less desirable option for .
