Autologous (Non vascularized) fibular grafting with cancellous bone grafting for treatment of femoral head osteonecrosis (Ficat and Arlet stage 1 2a 2b 3)

Abstract

Avascular necrosis of the femoral head is a multifaceted process that leads to articular incongruity and subsequent osteoarthrosis of the joint. Clinicians concur that primary treatment should focus on preservation of the natural surface of the joint; however, there has not been a consensus on how best to accomplish this. The purpose of this study was to evaluate the result of Autologous (non vascularized) fibular grafting with cancellous bone grafting for treatment of femoral head osteonecrosis (ficat and arlet classification grade 1, 2a, 2b, 3). This study describes the long-term results of core decompression with non-vascular (free) fibular graft along with cancellous bone graft from tibia in avn hip in 25 patients with success in 84% of cases. None of the hips that had Ficat stage-I, stage-II A and stage-IIB disease needed a total joint replacement while FOUR hips that had stage –III needed joint replacement. The results of this study show that core decompression with non-vascular fibular graft with cancellous bone graft is a good option at younger age for AVN hip