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The Journal of Bone and Joint Surgery 82:290-1 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Michael A. Mont, M.D., Lynne C. Jones, Ph.D., David S. Hungerford, M.D., Sean P. Scully, M.D., Ph.D., James R. Urbaniak, M.D. and Roy K. Aaron, M.D.

TO THE EDITOR:

We read with interest "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. We believe that a comparison study of treatment methods for osteonecrosis of the femoral head is an intriguing idea, but we have numerous reservations concerning the construct and conclusions of this work.

The authors did not determine the size or location of the lesion and therefore do not know if the groups were really comparable with respect to the severity of the disease. Size has been shown to be extremely important in many studies of this disease2-5. We suggest that the authors measure the size of the lesions in Ficat stage-II and III hips1 and determine if size is indeed a predictor of which hips will respond well to core decompression or bone-grafting and which will not.

The . . . [Full Text of this Article]


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M. A. Mont, L. C. Jones, and D. S. Hungerford
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