Paper #17 - ISHA Annual Scientific Meeting 2016

Clinical Outcome of Arthroscopic Bone-grafting for Avascular Necrosis of Femoral Head: Minimum 2-year Follow-up

Sun-Jung Yoon, MD, PhD, Jeonju SOUTH KOREA
Myung Sik Park, Prof., Jeonju, Chonbuk SOUTH KOREA
Seung-Min Choi, MD, Jeonju SOUTH KOREA
Bareunchan Ju, MD, Jeonju SOUTH KOREA

Chonbuk National University Hospital, Jeonju, SOUTH KOREA

FDA Status Not Applicable

Summary: All arthroscopic autobone graft can be used to effectively treat avascular necrosis of the femoral head while simultaneously managing symatomatic FAI and labral tear.

Purpose: All arthroscopic autobone graft with addressing labral tear and femoral head deformity resulted in a significant symptom improvement in avascular necrosis of the femoral head compared to a control group in this retrospective study.

Methods: We compared 50 consecutive patients undergoing aoutogenous bone graft for avascular necrosis femoral head into two groups: Group I 20 and Group II. Group I, 20 patients were treated by all arthroscopic bone graft with labral repair and femoroplasty and, Group II 30 patients were only treated by an open bone-graft by the light bulb technique. At a minimum of 2 year, all patients were assessed using a modified Harris hip score (HSS), completed a patient satisfaction scale and analyzed radiologic results.

Result: All 50 patients were available follow-up at an average 35 months (range, 25 to 55). Hospital stay was significantly shorter in arthroscopic treatment group compared with open treatment group (P<0.01). At six weeks, HHS was significantly better in the arthroscopic treatment group (89; range 72 to 92) compared with open treatment group (72; range 66 to 84). Additionally, patient subjective outcome was significantly better in the arthroscopic treatment group until 6 months postoperatively. In both groups, HHS improved significantly at last follow-up, there was no radiological differences between two groups. However, the need for THA was not significantly reduce in the arthroscopic treatment group (3 of 20 hips [15%] versus control group (10 of 30 hips [33.3%])

Conclusions: All arthroscopic approach for avascular necrosis of the femoral head results in not only shorter hospital stay, early joint motion, and superior improvement at early postoperative period, but also effectively treating concomitant labral tear and impingement.