Osteonecrosis of the femoral head (ONFH) is a painful and disabling condition, which most commonly involves the hips of young patients. But despite of the high incidence, treatment is still has not been definitely identified. We performed a modified muscle pedicle bone graft (MPBG) technique using anterior one-third of gluteus medius (GM) attached to the greater trochanter (GT) in ONFH. The purpose of this study was to evaluate the effectiveness of our technique on ONFH in ARCO stage II and III patients. Between June 2007 and March 2015, 24 hips were treated by our technique, who were able to follow up at least 2 years. The group was consisted of 15 men and 8 women, mean age of 36 years at the time of surgery. Mean follow-up was 5 years. Twenty of 24 hips hips had no progression of necrotic lesions. The postoperative scintigrams showed increased blood flow in the 3 month follow up evaluation. But 4 hips underwent THA at the mean follow-up of 6 years after the surgery, and considered as “failure”. Excluding the 4 failed cases, the mean Harris hip score was improved from 54 points to 85 points at the last follow up. Through our new technique, we showed 83% of survival rate by average of 5 year follow up. And compared to other reports, our technique showed relatively good survival rate and clinical outcomes. Therefore, we suggest this modified technique as one of promising treatment of choices for young patients with ARCO stage II or III ONFH.
There is no single standardised method of measuring
the orientation of the acetabular component on plain radiographs
after total hip arthroplasty. We assessed the reliability and accuracy
of three methods of assessing anteversion of the acetabular component
for 551 THAs using the PolyWare software and the methods of Liaw
et al, and of Woo and Morrey. All measurements of the three methods
had excellent intra- and inter-observer reliability. The values
of the PolyWare software, which determines version of the acetabular
component by edge detection were regarded as the reference standard.
Although the PolyWare software and the method of Liaw et al were similarly
precise, the method of Woo and Morrey was significantly less accurate
(p <
0.001). The method of Liaw et al seemed to be more accurate
than that of Woo and Morrey when compared with the measurements
using the PolyWare software. If the qualified lateral radiograph
was selected, anteversion measured using the method of Woo and Morrey
was considered to be relatively reliable. Cite this article:
