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KMID : 0922220090090010021
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Journal of the Korean Musculoskeletal Transplantation Society
2009 Volume.9 No. 1 p.21 ~ p.25
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Uncemented Total Hip Arthroplasty after Failed Free Vascularized Fibular Grafting for Osteonecrosis of the Femoral Head
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Kim Hyoung-Min
Kim Youn-Soo
Jeong Chang-Hoon
Moon Chan-Woong
Park Il-Jung
Kim Seung-Min
Lee Gi-Haeng
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Abstract
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Purpose: This study aimed at intraoperative attention points and postoperative results in patients who had undergone uncemented total hip arthroplasty after failed free vascularized fibular graft for osteonecrosis of the femoral head.
Materials and Methods: 16 patients (17 hips) who had underwent uncemented THA after failed FVFG between November 1991 and March 2006 were retrospectively reviewed. The mean age was 49.3 years at the time of procedure. Intraoperativery, high speed burr and fiber optic light source were used for the removal of grafted bone, and the position of the broach was identified under the C-arm image intensifier before the insertion of the stem. Clinical results were evaluated with Harris Hip Score, and radiological results were evaluated with the stability, osteolysis and position of the stem on simple radiographs.
Results: At the last follow-up, Harris Hip Score was 91.3 points which was compared with 52.7 points before the THA. The position of the stems was satisfactory and they were stable in all cases. One acetabular revision was performed at 9 years and 10 months after FVFG.
Conclusion: In performing of uncemented THA after failed FVFG, intraoperative use of special equipments such as high speed burr, fiber optic light source, and C-arm would be valuable methods of correct insertion of the femoral stem and avoidance of complication.
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KEYWORD
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Osteonecrosis of femoral head, Total hip replacement arthroplasty, Free vascularized fibular graft
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