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The Journal of Bone and Joint Surgery 82:289 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Stuart B. Goodman, M.D., Ph.D., Sean P. Scully, M.D., Ph.D., James R. Urbaniak, M.D. and Roy K. Aaron, M.D.

TO THE EDITOR:

It was with great interest that I read "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. The authors compared vascularized fibular grafting performed at Duke University Medical Center with core decompression performed at Brown University School of Medicine. Among the hips that had Ficat stage-II or III disease1, the rate of eventual total joint arthroplasty after vascularized fibular grafting was significantly lower than that after core decompression (p < 0.0001).

While reviewing this article, I noted several potential biases that warrant further comment from the authors. First, on page 1271, column 2, paragraph 3, the authors state: "Survival, with total hip arthroplasty as the end point, was compared between the groups." Core decompression, if performed properly, is a relatively quick operation with low morbidity. In contrast, vascularized fibular grafting is . . . [Full Text of this Article]


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J. D. Witt and S. P. Scully
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J. Bone Joint Surg. Am., December 1, 2000; 82(12): 1804-a - 1804.
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