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The Journal of Bone and Joint Surgery 82:1804 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Letters to The Editor

Age Bias and Choice of Intervention for Treatment of Avascular Necrosis

J. D. Witt, F.R.C.S., F.R.C.S.(Orth) and Sean P. Scully, M.D.Ph.D.

Department of Orthopaedic Surgery, The Middlesex Hospital, Mortimer Street, London W1N 8AA, United Kingdom
Division of Orthopaedic Surgery, Musculoskeletal Oncology Section, Duke University Medical Center, Box 3312, Durham, North Carolina 27710, E-mail address: scull002@mc.duke.edu

To The Editor:

Regarding the article "Survival Analysis of Hips Treated with Core Decompression or Vascularized Fibular Grafting Because of Avascular Necrosis" (80-A: 1270-1275, Sept. 1998), by Scully et al., I am not certain that, from the data presented, firm conclusions can be made when comparing these two treatment modalities. The main reasons for this are the significant age differences of patients in the Ficat stage-II and stage-III groups and the end point the authors have chosen for failure - conversion to total hip arthroplasty.

No clinical data are presented in terms of pain scores or functional evaluation of patients, and, therefore, one cannot say . . . [Full Text of this Article]


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