Free vascularized fibular transfer for femoral head osteonecrosis: donor and graft site morbidity.

Published

Journal Article

BACKGROUND: Autogenous vascularized fibular transfer is used effectively for a variety of complex reconstructive procedures. Published series demonstrating the morbidity associated with its harvest have, understandably, been relatively small, and graft site (hip) complications have not been reported. This report describes both the donor and the graft site morbidity associated with use of vascularized fibular transfer to treat osteonecrosis of the femoral head. METHODS: Between 1990 and 2006, 1270 free vascularized fibular grafts were used to treat osteonecrosis of the femoral head in 946 consecutive patients. All procedures and follow-up examinations were performed by one of two surgeons. Subjective and objective findings were recorded on standardized examination sheets at routine postoperative intervals. Data were analyzed to determine the morbidity associated with donor and graft sites. RESULTS: There were 215 complications (a 16.9% rate) at the time of follow-up, at an average of 8.3 years, after the 1270 procedures. Of these complications, 146 (11.5%) and sixty-nine (5.4%) were referable to the donor and graft sites, respectively. A major complication requiring an additional surgical procedure or chronic pain management occurred after fifty-four (4.3%) of the 1270 procedures. CONCLUSIONS: A measurable but acceptable morbidity risk is associated with vascularized fibular transfer for the treatment of osteonecrosis of the hip. Major complications are not frequent, and many minor complications are transient and improve over time. Risks can be minimized when specific technical principles are followed.

Full Text

Duke Authors

Cited Authors

  • Gaskill, TR; Urbaniak, JR; Aldridge, JM

Published Date

  • August 2009

Published In

Volume / Issue

  • 91 / 8

Start / End Page

  • 1861 - 1867

PubMed ID

  • 19651942

Pubmed Central ID

  • 19651942

Electronic International Standard Serial Number (EISSN)

  • 1535-1386

Digital Object Identifier (DOI)

  • 10.2106/JBJS.H.01105

Language

  • eng

Conference Location

  • United States