A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up
Abstract Background To compare the mid-long-term clinical and radiological outcomes between a combination of cortico-cancellous iliac bone graft with vascularized greater trochanter flap (Group A) and isolate iliac bone graft (Group B) in the treatment of Osteonecrosis of the Femoral Head (ONFH). Me...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2613-1 |
| _version_ | 1818295521238843392 |
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| author | Wenjun Feng Jinlun Chen Keliang Wu Lu Lu Peng Deng Pengcheng Ye Houran Cao Jie Li Jianchun Zeng Ke Jie Xinyu Qi Yirong Zeng |
| author_facet | Wenjun Feng Jinlun Chen Keliang Wu Lu Lu Peng Deng Pengcheng Ye Houran Cao Jie Li Jianchun Zeng Ke Jie Xinyu Qi Yirong Zeng |
| author_sort | Wenjun Feng |
| collection | DOAJ |
| description | Abstract Background To compare the mid-long-term clinical and radiological outcomes between a combination of cortico-cancellous iliac bone graft with vascularized greater trochanter flap (Group A) and isolate iliac bone graft (Group B) in the treatment of Osteonecrosis of the Femoral Head (ONFH). Methods From January 2006 to December 2012, 123 patients (135 hips) who underwent abovementioned hip-preserving surgeries were included for analysis. Clinical outcomes were assessed based on Harris Hip Score (HHS) System and The Western Ontario and McMaster University Index (WOMAC) scores between the preoperative and the last follow-up. A series of postoperative X-rays were compared to preoperative images for radiological evaluation. Results The HHS in Group A and B were enhanced from 50.57 ± 3.39 to 87.60 ± 4.15 and from 50.24 ± 3.30 to 85.18 ± 6.45, respectively, which both showed significance between preoperative and postoperative latest follow-up (p < 0.001). Group A revealed better improvement in terms of HHS (p = 0.017). The WOMAC total, postoperative stiffness, difficulty subscale scores in Group A showed better outcomes when compared to Group B (p < 0.01), while pain improvement between these two groups revealed no significance (p = 0.402). Besides, Group A suggested better necrotic region repair (p = 0.020), but no femoral head collapse difference in terms of Association Research Circulation Osseous classification change was found (p > 0.05). Conclusions A combination of cortico-cancellous iliac bone graft and concurrent vascularized greater trochanter flap with the lateral femoral circumflex transverse branch has been proved can obtain better functional and radiological results than isolate iliac bone grafting, which is attributed to blood reconstruction of the femoral head. |
| first_indexed | 2024-12-13T03:48:58Z |
| format | Article |
| id | doaj.art-f3449c3707b442b9a1a55edd52b77338 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-13T03:48:58Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-f3449c3707b442b9a1a55edd52b773382022-12-22T00:00:46ZengBMCBMC Musculoskeletal Disorders1471-24742019-06-012011810.1186/s12891-019-2613-1A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-upWenjun Feng0Jinlun Chen1Keliang Wu2Lu Lu3Peng Deng4Pengcheng Ye5Houran Cao6Jie Li7Jianchun Zeng8Ke Jie9Xinyu Qi10Yirong Zeng11Guangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese Medicine, Linnan Medical Research Center of Guangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineThe First Affiliated Hospital of Guangzhou University of Chinese MedicineAbstract Background To compare the mid-long-term clinical and radiological outcomes between a combination of cortico-cancellous iliac bone graft with vascularized greater trochanter flap (Group A) and isolate iliac bone graft (Group B) in the treatment of Osteonecrosis of the Femoral Head (ONFH). Methods From January 2006 to December 2012, 123 patients (135 hips) who underwent abovementioned hip-preserving surgeries were included for analysis. Clinical outcomes were assessed based on Harris Hip Score (HHS) System and The Western Ontario and McMaster University Index (WOMAC) scores between the preoperative and the last follow-up. A series of postoperative X-rays were compared to preoperative images for radiological evaluation. Results The HHS in Group A and B were enhanced from 50.57 ± 3.39 to 87.60 ± 4.15 and from 50.24 ± 3.30 to 85.18 ± 6.45, respectively, which both showed significance between preoperative and postoperative latest follow-up (p < 0.001). Group A revealed better improvement in terms of HHS (p = 0.017). The WOMAC total, postoperative stiffness, difficulty subscale scores in Group A showed better outcomes when compared to Group B (p < 0.01), while pain improvement between these two groups revealed no significance (p = 0.402). Besides, Group A suggested better necrotic region repair (p = 0.020), but no femoral head collapse difference in terms of Association Research Circulation Osseous classification change was found (p > 0.05). Conclusions A combination of cortico-cancellous iliac bone graft and concurrent vascularized greater trochanter flap with the lateral femoral circumflex transverse branch has been proved can obtain better functional and radiological results than isolate iliac bone grafting, which is attributed to blood reconstruction of the femoral head.http://link.springer.com/article/10.1186/s12891-019-2613-1Osteonecrosis of the femoral headVascularized greater trochanter flapCortico-cancellous iliac bone graftHip-preservingOutcomes comparison |
| spellingShingle | Wenjun Feng Jinlun Chen Keliang Wu Lu Lu Peng Deng Pengcheng Ye Houran Cao Jie Li Jianchun Zeng Ke Jie Xinyu Qi Yirong Zeng A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up BMC Musculoskeletal Disorders Osteonecrosis of the femoral head Vascularized greater trochanter flap Cortico-cancellous iliac bone graft Hip-preserving Outcomes comparison |
| title | A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up |
| title_full | A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up |
| title_fullStr | A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up |
| title_full_unstemmed | A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up |
| title_short | A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up |
| title_sort | comparative study of cortico cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis a minimum 6 years follow up |
| topic | Osteonecrosis of the femoral head Vascularized greater trochanter flap Cortico-cancellous iliac bone graft Hip-preserving Outcomes comparison |
| url | http://link.springer.com/article/10.1186/s12891-019-2613-1 |
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