{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T13:06:55Z","timestamp":1793020015770,"version":"4.5.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":78,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Science Foundation for Young Scientists of China","award":["81804117"],"award-info":[{"award-number":["81804117"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Free vascularized fibular grafting was reported a favorable method to prevent the collapse of the femoral head. This study analyzed the mid- to long-term outcomes of avascular fibular grafting (AVFG) for osteonecrosis of the femoral head (ONFH) with 6- to 8-year follow-up. From March 2009 to March 2012, 34 patients (48 hips) were diagnosed with ONFH operated with AVFG in Jiangsu Province Hospital of traditional Chinese Medicine. We retrospectively reviewed the clinic outcomes of these patients and evaluated the differences in outcomes by diverse stages [Association Research Circulation Osseous (ARCO)] and types [China\u2013Japan Friendship Hospital (CJFH) classification] annually. The hip survival rate, Harris hip score (HHS), activity level and imaging stability were calculated. The average follow-up time was 6.7 years. At the last follow-up, 34 of 48 hips survived totally. According to the ARCO stage, the overall clinical success rate for hip preserving were 76.0% (19\/25) in II stage, 85.7% (12\/14) in IIIA stage and 33.3% (3\/9) in IIIB stage. Referring to the CJFH classification system, the hip survival rate were 100% (2\/2) in M type, 90.9% (10\/11) in C type, 77.8% (14\/18) in L1 type, 57.1% (8\/14) in L2 type and 0% (0\/3) in L3 type. The mean visual analog scale (VAS) score, HHS and Western Ontario McMaster Osteoarthritis index (WOMAC) were significantly improved at the final follow-up compared with pre-operative values (P &amp;lt; 0.001). The AVFG operation can increase the hip function and improve patients\u2019 lives quality. The mid- to long-term efficacy can satisfy fundamental life requirements, especially for those early-stage and small-scale patients who suffer ONFH to avoid or put off the time of total hip arthroplasty surgery.<\/jats:p>","DOI":"10.1093\/jhps\/hnab046","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T21:14:46Z","timestamp":1634764486000},"page":"274-281","source":"Crossref","is-referenced-by-count":15,"title":["Mid- to long-term results of modified avascular fibular grafting for ONFH"],"prefix":"10.1093","volume":"8","author":[{"given":"Peng","family":"Yuan","sequence":"first","affiliation":[{"name":"Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[{"name":"Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing Jiangsu 210000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Du","sequence":"additional","affiliation":[{"name":"Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing Jiangsu 210000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang-Quan","family":"Sun","sequence":"additional","affiliation":[{"name":"Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing Jiangsu 210000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Wang","sequence":"additional","affiliation":[{"name":"Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan-Ye","family":"Lin","sequence":"additional","affiliation":[{"name":"Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"2022040908021854700_hnab046-B1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.5435\/JAAOS-22-07-455","article-title":"Osteonecrosis of the femoral head: evaluation and treatment","volume":"22","author":"Zalavras","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"key":"2022040908021854700_hnab046-B2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/os.12857","article-title":"Epidemiological study based on china osteonecrosis of the femoral head database","volume":"13","author":"Tan","year":"2021","journal-title":"Orthop Surg"},{"key":"2022040908021854700_hnab046-B3","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1093\/jhps\/hny021","article-title":"The role of cell therapies and hip arthroscopy in the management of osteonecrosis: an update","volume":"5","author":"Papavasiliou Athanasios","year":"2018","journal-title":"J Hip Preserv Surg"},{"key":"2022040908021854700_hnab046-B4","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1093\/jhps\/hnaa020","article-title":"Outcome of tantalum rod insertion in the treatment of osteonecrosis of the femoral head with minimum follow-up of 1 year: a meta-analysis and systematic review","volume":"7","author":"Onggo","year":"2020","journal-title":"J Hip Preserv Surg"},{"key":"2022040908021854700_hnab046-B5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/jhps\/hnz054","article-title":"Subchondral insufficiency fractures of the femoral head: systematic review of diagnosis, treatment and outcomes","volume":"7","author":"Gaudiani","year":"2020","journal-title":"J Hip Preserv Surg"},{"key":"2022040908021854700_hnab046-B6","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4103\/0019-5413.143911","article-title":"Management of femoral head osteonecrosis: current concepts","volume":"49","author":"Tripathy","year":"2015","journal-title":"Indian J Orthop"},{"key":"2022040908021854700_hnab046-B7","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.arth.2018.09.041","article-title":"Outcomes of conversion total hip arthroplasty from free vascularized fibular grafting","volume":"34","author":"Ryan","year":"2019","journal-title":"J Arthroplasty"},{"key":"2022040908021854700_hnab046-B8","doi-asserted-by":"crossref","first-page":"24","DOI":"10.11138\/jts\/2016.4.1.024","article-title":"Failed vascularized fibular graft in treatment of osteonecrosis of the femoral head. 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