Transplantation of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels in the treatment of osteonecrosis of the femoral head

Cui,Guofeng; Wei,Rong; Hou,Chunying; Bi,Zhenggang

doi:10.3892/etm.2016.3202

Transplantation of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels in the treatment of osteonecrosis of the femoral head

Authors:
- Guofeng Cui
- Rong Wei
- Chunying Hou
- Zhenggang Bi
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Affiliations: Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China, Department of Orthopedics, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471009, P.R. China
Published online on: March 30, 2016 https://doi.org/10.3892/etm.2016.3202
Pages: 2201-2208
Copyright: © Cui et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of this study was to evaluate the efficacy and clinical application of iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels for the treatment of Association for Research on Osseous Circulation (ARCO) stage II‑III osteonecrosis of the femoral head (ONFH) in young adults. In total, 35 patients with ONFH at ARCO stage II‑III were treated with iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels. Patients were classified according to etiological factors and ARCO stages. Postoperative clinical assessment was accomplished with Harris hip scores (HHSs), and ARCO stage change was evaluated with imaging. All 35 patients completed the follow‑up. The HHS results indicated that hip function was improved significantly from the preoperative status of 56.53±7.66 points to the postoperative status of 87.49±5.89 points (P<0.0001). Postoperative imaging displayed apparent osteogenesis and satisfactory structural remodeling in 32 patients, presenting no staging progress. Three patients exhibited mild collapse (<2 mm) compared with preoperative collapse. No patients developed osteoarthritis or required total hip arthroplasty. The clinical success rate was 91.43%. Iliac bone flaps pedicled with sartorius muscular fascia around superficial circumflex iliac vessels is a feasible means for treating ARCO stage II‑III ONFH in young adults, who have abundant blood circulation, good osteogenesis and function of the hip. It is also an effective means for retaining the femoral head.

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