Muscle Pedicle Graft in Avascular Necrosis Femoral Head
DOI:
https://doi.org/10.17140/ORTOJ-2-108Keywords:
Single Photon Emission Computed Tomography (SPECT), Muscle pedicle, VertebraAbstract
Aims: To assess the effectiveness of muscle pedicle graft in avascular necrosis (AVN) head femur in Grade 1 and Grade 2 AVN of femoral head grade 1 and grade 2 as head sparing procedure.
Method: The pixel count in Tc-99 bone scan single photon emission computed tomography (SPECT) was used as perfusion analysis through a standardized procedure of assessment at six monthly intervals. Comparisons of the scan and the counts at each interval was used to determine whether the procedure was producing a beneficial effect and to what extent. The cases were followed-up for a minimum period of two years.
Result: It was discovered that the comparative ratios had a bearing on the clinical improvement and could be used as a predictor variable for the outcome. They also had a significant prognostic value.
Conclusions: Muscle pedicle graft in Grade 1 and Grade 2 AVN femoral head does benefit the patient. The SPECT analysis of the Tc-99 bone scan can be used as a monitor and reasonably predict the outcome and adverse end results.
References
Ficat RP, Arlet J. Ischaemia and necrosis of bone, Baltimore etc. Williams and Wilkin. 1980; 171-182.
Canale ST, Beaty JH. Management of osteonecrosis of head of femur. Campbell’s Operative Orthopaedics. 11th ed. Philadel-phia, USA: Elsevier; 2007.
Bakshi DP. Treatment of AVN of the femoral head by drilling and muscle pedicle bone grafting. J Bone Joint Surg Br. 1991; 73(2): 241-245. Web site. http://www.bjj.boneandjoint.org.uk/ content/73-B/2/241.short. Accessed November 13, 2016.
Collier BD, Carrera GF, Johnson RP, et al. Detection of femo-ral head avascular necrosis in Adults by SPECT. J Nucl Med. 198; 26(9): 979-987. Web site. http://europepmc.org/abstract/ med/3875700. Accessed November 13, 2016.
Hull A, Hattner RS, Vincente S. Prospective Scintigraphic evaluation of avascular necrosis (AVN) of the femoral head in renal transplant recipients. J Nucl Med. 1979; 20(1): 646-650. doi: 10.1016/S0009-9260(85)80012-X
Droll KP, Prasad V, Ciorau A, Gray BG, McKee MD. The use of postoperative bone scintigraphy to predict graft reten-tion. Can J Surg. 2007; 50(4): 261-265. Web site. http://search. proquest.com/openview/c72d1a9bfbb03055958cdb4eae994bc 5/1?pq-origsite=gscholar&cbl=41665. Accessed November 13, 2016.
Marcus ND, Enneking WF, Massam RA. The silent hip in idiopathic aseptic necrosis: Treatment by bone grafting. J Bone Joint Surg Am. 1973; 55(7): 1351-1366. Web site. http://jbjs. org/content/55/7/1351. Accessed November 13, 2016.
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