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The Journal of Bone and Joint Surgery, Vol 73, Issue 9 1357-1364, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Structural bone-grafting for early atraumatic avascular necrosis of the femoral head
PD Buckley, PF Gearen and RW Petty
Department of Orthopaedics, University of Florida College of Medicine, Gainesville 32610.
Between 1970 and 1987, nineteen patients, thirty-one to fifty-five years
old, had twenty core-decompression procedures with corticocancellous
bone-grafting for Stage-I or II atraumatic avascular necrosis of the
femoral head. A tibial autogenous graft was used in three hips; a fibular
autogenous graft, in seven hips; and a fibular allograft, in ten hips.
Treatment was considered to have failed when there was clinical or
roentgenographic evidence of progression of the necrosis. Eighteen patients
who had a minimum follow-up of two years (average, eight years; range, two
to nineteen years) were asymptomatic, with no evidence of progression of
the necrosis or collapse of the affected segment. In two hips, the necrotic
segment of the femoral head collapsed within one year after the operation,
and a replacement arthroplasty was carried out.
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