VIABLE ILIAC BONE GRAFTING FOR OSTEONECROSIS OF FEMORAL HEAD IN
YOUNG PATIENTS UNDER 40 YEARS
Taek Rim Yoon, M.D., Sung Man Rowe, M.D., Jae Yoon Chung, M.D.,
Eun Sun Moon, M.D., Eun Kyoo Song, M.D.
Department Of Orthopedics, Chonnam National University Hospital, Gwangju, Korea

The method for treating an osteonecrosis of the femoral head is controversial. The purpose of this study was to evaluate the efficacy of a viable iliac bone graft for treating an osteonecrosis of the femoral head. Thirty hips in 21 young patients who underwent a viable iliac graft(9 hips-vessel pedicle iliac bone graft and 21 hips-muscle pedicle iliac bone graft). The clinical and radiographic results were evaluated after an average of 2 years (18 to 40 months). Their ages ranged from 20 to 39 years of age with an average of 30 years. Six were classified as being in Ficat stage 2 and 24 hips were in stage 3. The radiographical results were evaluated by a serial follow up of roentgenography and anteroposterior and lateral pinhole bone scintigraphy. All patients expressed satisfaction except one. Overall, excellent results were reported in 9, good in 18, fair in 2 and poor in 1. One patient who reported the poor result suffered from systemic lupus erythematosus and required replacement surgery as a result of further collapse and pain. In all other cases, the serial roentgenographic examination revealed a gradual incorporation of the grafted bone. The scintigraphic examination revealed a gradual increase in the uptake revealing increased blood supply to the femoral head. The overall results of the viable iliac bone graft technique were very satisfactory. This technique is recommended particularly for the young patients with osteonecrosis. Pinhole bone scintigraphy was quite useful for evaluating the healing process after the revascularization procedure.