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Treatment of femoral head osteonecrosis in patients with systemic lupus erythematosus by free vascularised fibular grafting

Department of Orthopaedic Surgery, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, Shanghai, China

CQ Zhang

Department of Orthopaedic Surgery, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, Shanghai, Chinazhangchqin{at}yahoo.cn

SB Chen

Department of Orthopaedic Surgery, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, Shanghai, China

JG Sheng

Department of Orthopaedic Surgery, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, Shanghai, China

DX Jin

Department of Orthopaedic Surgery, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, Shanghai, China

BF Zeng

Department of Orthopaedic Surgery, Shanghai Jiao Tong University, Shanghai Sixth People’s Hospital, Shanghai, China

The purpose of this study was to review the radiographs of symptomatic femoral head osteonecrosis in patients with systemic lupus erythematosus (SLE) and to assess the results of treatment using free vascularised fibular grafting. We retrospectively reviewed 50 patients (80 hips) with SLE who underwent free vascularised fibular grafting for osteonecrosis of the femoral head. All patients were followed up for at least 2 or more years (average, 4.3 years). The mean Harris hip score improved from 72 to 88. At the latest follow-up, we found improved or unchanged radiographs in 12 of initially Stage II hips and in 60 of 64 Stage III or IV hips. No hips failed treatment and underwent total hip arthroplasty. The data suggest that free vascularised fibular grafting was successful in maintaining joint function and in delaying the need for joint replacement procedure.

Key Words: femoral head osteonecrosis • free vascularised fibular graft • systemic lupus erythematosus

Lupus, Vol. 18, No. 12, 1061-1065 (2009)
DOI: 10.1177/0961203309106490


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