Hip arthroplasty after failed free vascularized fibular grafting for osteonecrosis in young patients

This study reports the results of total hip arthroplasty (THA) for osteonecrosis after failed free vascularized fibular grafting (FVFG) at a 5-year minimum follow-up. In this study, 73 patients (89 THA) were treated for failed FVFG, and survival of THA was discussed. Clinical outcome was measured using a pain and function survey (possible 91 points) in 84 hips and Harris Hip scores (HHS, 100 possible points) for 52 hips. Survival was 94.4% at 5 years, 85.4% at 10 years, and 82% overall. Average HHS at final follow-up improved to 77.5 (P < .05). The average clinical result after THA was 68 of 91 points. In this study, 58% of patients had a good or excellent HHS. The overall revision rate for proximal ingrowth stems was 13% at an average follow-up of 9.1 years. Only 4 patients required stem revision for loosening (7.4%). THA after FVFG provides improved functional results comparable to the published results of primary THA in osteonecrosis in young patients.