Nonvascularized bone grafting defers joint arthroplasty in hip osteonecrosis.
A variety of nonvascularized bone grafting techniques have been proposed with varying degrees of success as treatment alternatives for osteonecrosis of the femoral head. The success of these procedures may be enhanced using ancillary growth and differentiation factors. We retrospectively reviewed 33 patients (39 hips) with osteonecrosis of the hip who had nonvascularized bone grafting procedures with supplemental OP-1. We compared the outcomes in this cohort to similar patients treated nonoperatively or with other nonvascularized bone grafting procedures. We used a trapdoor to make a window at the head-neck junction to remove necrotic bone and packed the excavated area with autogenous cancellous bone graft, marrow, and OP-1. The minimum followup was 24 months (mean, 36 months; range, 24-50 months). We performed no further surgery in 25 of 30 small- and medium-sized lesions (80%) but did in two of nine large lesions. Hips with Ficat Stage II disease were not reoperated in 18 of 22 cases during the followup periods. Our short-term results compare similarly to nonoperative treatment and other reports of nonvascularized bone grafting. With the addition of ancillary growth factors, these procedures effectively reduce donor site morbidity and may defer joint arthroplasty in selected patients.
Duke Scholars
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Related Subject Headings
- Treatment Outcome
- Treatment Failure
- Transforming Growth Factor beta
- Time Factors
- Severity of Illness Index
- Retrospective Studies
- Reoperation
- Osseointegration
- Orthopedics
- Middle Aged
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Treatment Outcome
- Treatment Failure
- Transforming Growth Factor beta
- Time Factors
- Severity of Illness Index
- Retrospective Studies
- Reoperation
- Osseointegration
- Orthopedics
- Middle Aged