FUNCTIONAL OUTCOME OF CORE DECOMPRESSION WITH FIBULAR GRAFTING IN THE MANAGEMENT OF AVASCULAR NECROSIS OF THE FEMORAL HEAD
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 34
Abstract
BACKGROUND Avascular necrosis of the femoral head is a condition affecting people between ages 30 and 50 years, most often bilateral. Core decompression with bone grafting is a commonly done procedure in early stages of avascular necrosis to prevent its further progression. Very few studies on this issue have been done in India. This study aims to determine the functional outcome of core decompression with fibular grafting in different stages of avascular necrosis femoral head. MATERIALS AND METHODS This is a prospective observational study of 30 patients with avascular necrosis of the femoral head stages I, IIA, IIB & III admitted in Department of Orthopaedics, Government Medical College, Kottayam from February 2012 to August 2013. RESULTS The age of the patients ranged from 20 years to 51 years. Of the 30 patients, most of them belonged to the age group between 30 and 40 years (53.3%). The male to female ratio was 4:1. Out of 30 patients, 33.3% had right sided, 26.6% patients had left side and 40% of patients had bilateral involvement respectively. Pre-operative Ficat stages were - 8.1% with stage I disease, 32.4% with stage IIA, 32.4% with stage IIB and 27.1% with stage III disease. Ficat stage I and IIA there is improvement in range of movements, good functional outcome, improved mobility and pain relief. There is also no radiological worsening as indicated by the post-operative Ficat staging. In Stage IIB and III, there is no significant improvement in the range of motion. But the patients had significant pain relief, improved mobility and no radiological worsening. CONCLUSION Core decompression with fibular grafting was found to be a good treatment option for patient with Ficat and Artlet Stages I and IIA avascular necrosis of femoral head. In Stage IIB and III, procedure may be tried before going in for a Total Hip Replacement especially if the patient already has a good range of motion at the hip as it provides pain relief and improve mobility, thereby providing a functional hip till the disease process worsens.
Authors and Affiliations
Rohith Daniel, Tomichan Tomichan, Babukutty E. C
Keywords
Related Articles
- EP ID EP571082
- DOI 10.18410/jebmh/2018/514
- Views 89
- Downloads 0
VARIATIONS IN THE DIVISION OF COMMON CAROTID ARTERY AND IN THE COURSE OF SUPERIOR THYROID ARTERY: A CASE REPORT
Common carotid arteries on either side show frequent variations in their anatomy. This poses interpretational difficulties during interventional procedures in surgery, interventional radiology and angiography. Knowledge...
MATERNAL ANAEMIA AND NEWBORN MORBIDITY IN A TERTIARY HOSPITAL
BACKGROUND Anaemia is the commonest nutritional deficiency disorder in the world and in India prevalence in pregnancy is 50-80%. It is a risk factor for preterm delivery, low birth weight, stillbirth and foetal anaemia....
COMPARISON OF CORNEAL TOPOGRAPHY WITH AUTOMATED REFRACTOMETRY IN THE ASTIGMATISM OF KERATOCONUS
BACKGROUND Keratoconus is commonly associated with irregular myopic astigmatism. This astigmatic change is compared and analysed with the corneal topography and automated refractometry. MATERIALS AND METHODS 35 eyes of 2...
PREVALENCE OF BLINDNESS DUE TO POSTERIOR SEGMENT DISORDERS: A RURAL POPULATION BASED STUDY
To estimate the prevalence of blindness due to posterior segment disorders which include diabetic retinopathy, retinal detachment, age related macular degeneration in rural area in central India of Wardha District. MATER...
STABILISATION OF PHALANGEAL AND METACARPAL FRACTURES WITH JESS FIXATION
BACKGROUND The human hand is the most vulnerable part of the body prone to a variety of injuries especially in industries, agricultural fields and adding to this increased road traffic accidents resulting in high inciden...