Hong Kong Journal of Orthopaedic Surgery

Volume 5 Number 1, April 2001

Use of vascularised iliac crest bone graft to treat non-traumatic avascular necrosis of the femoral head in young adults

Chan SK, Ho YF
Department of Orthopaedics and Traumatology, Caritas Medical Centre, Hong Kong

This study reported our experience of treating nine young patients with non-traumatic avascular necrosis of the femoral head using the vascularised iliac crest bone graft technique with a mean follow-up druation of 3.5 years. The age of the patients ranged from 24.0 to 41.0 years with a mean age of 31.0 years. Three patients had bilateral hip involvement and a total of 12 hips were treated using this technique. Preoperatively, all patients presented with hip pain in either one or both hips. Eight hips became pain-free and four hips had the pain reduced after the operation. Most of the hip functional scores were well maintained. From the X-rays at subsequent follow-up visits, the femoral head configuration was shown to be maintained in 11 (92.0%) hips. The complications encountered were partial superficial skin loss in one case and thigh numbness due to nerve injury in two others. So far, no cases require conversion to hip arthroplasty. A larger and longer-term study is needed to evaluate the effectiveness of this technique. (Hong Kong j. orthop. surg. 2001;5(1):24-31)

Key Words: Adult; Femoral head necrosis/surgery; Graft survival; Ilium/transplantation



由 1994年至1999年3月,本院以帶蒂髂崤骨移植術治理了12個非創傷性股骨頭無血壞死症。病者年齡平均為24.0至41.0歲(平均年齡31.0歲),平均隨訪期為3.5年。九名病者中,有三名左 右股骨頭同受影響。術前所有病者都有不同程度的疼痛。結果為八個臗關節痛楚全消,四個減輕。關節其它功能都能保持。X射線照片顯示,11(92.0%)個關節及股骨頭維持完整。併發症包括一例傷口需施植皮手術及兩例因神經受損引致大腿麻痺。至今無一例需進行關節置換手術。我們確認需進行更大型的長期研究以評估帶蒂髂崤骨移植術的成效。

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