大腿骨頭壊死症に対する遊離血管柄付き腓骨移植術の中期成績

抄録

  Osteonecrosis of the femoral head (ONFH) is a devastating disease that affects young adults. Joint-preserving surgery is important. Free vascularized fibular grafting (FVFG) is a joint-preserving surgery that has been reported to be successful for patients with early stages of osteonecrosis. We retrospectively reviewed the results in seven patients (ten hips) who had undergone FVFG for the treatment of ONFH between 2011 and 2020 in our institution. The average duration of follow-up was 5.2 years (range, 3-12 years). The Japanese Orthopaedic Association Score improved from 63 to 82 points at the time of the final follow-up evaluation. One hip was converted to total hip arthroplasty after 3 years; however, all other hips survived and pain-free good range of motion was restored. Complications were: five patients had flexion contracture of flexor hallucis longus, one had undisplaced proximal femoral fracture, and one had lateral femoral skin nerve palsy. FVFG is an essential salvage procedure of ONFH, especially in younger patients in the early precollapse stages of osteonecrosis.