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The Journal of Bone and Joint Surgery 82:289-90 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Kim J. Chillag, M.D., Sean P. Scully, M.D., Ph.D., James R. Urbaniak, M.D. and Roy K. Aaron, M.D.

TO THE EDITOR:

In the article "Survival Analysis of Hips Treated with Core Decompression or Vascularized Fibular Grafting Because of Avascular Necrosis" (80-A: 1270–1275, Sept. 1998), Scully et al. compared the results of core decompression and vascularized fibular grafting done at two different centers. The conclusions, with the end point of success being avoidance of a total hip arthroplasty, seemed to favor vascularized fibular grafting for Ficat stage-II and III lesions1, with little difference between the results of the two methods when used to treat Ficat stage-I lesions.

It is vital for practitioners who manage patients with avascular necrosis to assess the efficacy of treatment measures. This article, however, still leaves open the question of the efficacy of core decompression and vascularized fibular grafting. I have two major concerns regarding the comparison of these two treatment groups.

My first concern is that the two groups were not treated similarly . . . [Full Text of this Article]


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