Free Vascularized Fibula Grafting for the Treatment of Osteonecrosis of the Femoral Head

Abstract

Sixty-five patients (88 hips) who received free vascularized fibula grafting for treatment of osteonecrosis of the femoral head at the University of Pittsburgh Medical Center, were followed for at least 3 years (average followup, 5.5 years; range, 3–7 years). There were 46 men and 19 women with an average age of 37 years (range, 20–52 years). All patients were evaluated using history, physical examination, Harris Hip Score, anteroposterior and lateral radiographs, and magnetic resonance images. The classification system of Steinberg et al (1995) was used to stage the disease. At final evaluation, 31 hips (35.2%) were rated excellent (Harris Hip Score >90 points, minimal or no pain), 30 hips (34.1%) were rated good (Harris Hip Score 80–89 points, slight pain), seven hips (8%) were rated fair (Harris Hip Score 70–79, slight or moderate pain), and 20 hips (22.7%) were rated poor (Harris Hip Score