Managementt o f non traumatic A vascular Necrosis off Femoral Head at precollapse stage with Core Decompression and tibial Bone Grafting

Abstract

 Avascular necrosis have always presented great challenges to orthopedic surgeons and patients, remain in many ways today the unsolved dilemma. Varieties of non-vascularized bone grafting techniques preceded by core decompression have been proposed with varying degrees of success. O bb j ee cc t i vv ee ss : The aim of this study is to review the the value of core decompression and non-vascularized tibial bone strip graft treatment for early stages of non-traumatic osteonecrosis stage II & III according to stein burg staging . M ee t hh oo dd ss : prospectively reviewed 26 patients (32 hips) with osteonecrosis of the femoral head between June 2006 and December 2013 at Imam Ali hospital in Sader city & Al-Wasity teaching hospital. Inclusion criteria were all patients ages 19 years to 50 years and in Stein burg stages II and III . Mean follow-up for 3 year. Exclusion criteria were stage I, IV, V and VI .We used Phemister technique to make a window at the posterior aspect of greater trochanter to remove necrotic bone and packed the excavated area with cortico-cancelloustibial bone strip graft. This study was taking into account ethical evaluation and approval by scientific committee of Arab board. R ee ss uu l t ss: The reported results of treatment for femoral head avascular necrosis was (87.6%) success rate of hips in our cohort of patients with core decompression &non-vascularized tibial bone strip C oo nn cc l uu ss i oo nn ss : None vascularized tibial bone graft effectively reduce donor site morbidity and may defer jointarthroplasty in selected patient stein burg staging