Surgical technique: Free vascularized fibula graft for avascular necrosis


Book Section

© Springer Science+Business Media New York 2015. Avascular necrosis (AVN) or osteonecrosis of the femoral head (ONFH) is a commoncause of hip pain and disability in a young patient demographic with an average age of mid-30s.If left untreated, approximately 80 % of cases of ONFH will result in femoral head collapse and hip degeneration necessitating total hip arthroplasty (THA) in a mean of 2 years. The relatively poor outcomes and requisite lifestyle changes associated with THA inthis patient population have challenged surgeons to seek alternative treatment options. Vascularized bone grafts have been shown to have better radiographical and clinical results compared to nonvascularized bone grafts. Of these options, free vascularized fibular graft (FVFG) is the treatment of choice for its structural and vascular support within the femoral head. Improved technique has led to complication rates, including donor-site morbidity, statistically similar to that of nonvascular fibular grafts. When used in young patients with precollapse ONFH, FVFG can greatly improve patient outcome, with lower rates of conversion to THA than other treatment modalities.

Full Text

Duke Authors

Cited Authors

  • Mather, RC; Federer, AE; Ruch, DS

Published Date

  • January 1, 2015

Book Title

  • Hip Arthroscopy and Hip Joint Preservation Surgery

Start / End Page

  • 1061 - 1071

International Standard Book Number 13 (ISBN-13)

  • 9781461469643

Digital Object Identifier (DOI)

  • 10.1007/978-1-4614-6965-0_94

Citation Source

  • Scopus