Analysis of long-term outcomes of double-strut bone graft for osteonecrosis of the femoral head

Abstract

Objective: To analyze the long-term effect of double-strut bone graft for osteonecrosis of the femoral head (ONFH).

Methods: A total of 366 adult patients with ONFH in 466 hips underwent double-strut bone graft from March 1988 to January 1999. Of them, 186 patients with 206 hips and an average age of 32.2 years (range, 20-60 years) were followed up for more than five years, up to January 2006. Based on the Association Research Circulation Osseous (ARCO) classification, there were 36 hips in stage IIB, and 30, 40, 40, 32 and 28 in stage IIC, IIIA, IIIB, IIIC and IV, respectively. The functional results of affected hips were evaluated by the hundred forked method.

Results: Hip pain in all patients disappeared or alleviated greatly after the operation. The height of the femoral head improved to various extents, and the range of motion of the hip joint increased. The patients were followed up for 5-16 years, (average 10.5 years). The total scores increased significantly postoperatively (P < 0.01). The rate of excellent and good results was 83.3%, 80.0%, 75.0%, 65.0%, 40.6% and 28.6% in stage IIB, IIC, IIIA, IIIB, IIIC and IV, respectively (63.6% for the whole group).

Conclusion: The long-term effect of double-strut bone graft for ONFH is satisfactory in relation to staging of ONFH. Favorable results can be expected in young ONFH patients in stage IIB, IIC, and IIIA, IIIB.