Analysis of Outcome of Osteonecrosis of Femoral Head Treated by Core Decompression and Fibular Strut Grafting

Introduction Osteonecrosis is a progressive disease of impaired osseous blood flow with wide ranging etiology and poorly understood pathogenesis commonly affecting patients in third, fourth and fifth decade of life. Most of these are idiopathic and are at young when diagnosed. There are various modalities of conservative and surgical methods to halt the natural history of the disease. Core decompression and fibular strut grafting one of the simplest of the joint preserving surgeries and widely reported in the past few decades. A wide range of success rates has been reported with cortical strut grafting techniques in various studies, ranging from 61 % to 90 %. Materials and Methods The present study includes 22 cases of osteonecrosis of femoral had treated by core decompression and fibular strut grafting at our institute. Clinic radiological examination of all cases done and included in the study based on inclusion and exclusion criteria. The patients were also assessed preoperatively and postoperatively with the Harris Hip score. All patients underwent core decompression and fibular strut grafting in the supine position through standard postero-lateral approach. Patients were followed up 3 month, 6 months and as recent follow-up as patients came after the surgery. Conclusion Osteonecrosis of femoral head is an important disease affecting hips at younger age. t important to diagnose and treat osteonecrosis as early as feasible to prevent progression of the disease and fore stall the need for THR. In order to provide mechanical support to the infarct to prevent collapse / further collapse the graft should placed in the center of the lesion and under sub-chondral bone. Fibular strut graft is easy to obtain, does not leave behind much functional or cosmetic problems at donor site. It provides biological and mechanical fixations.