Objective:To document the clinical result of total hip arthroplasty following failure of core decompression and allogenic fibular graft. Methods:Thirty-four hip arthroplasty in thirty-one patients who had previous undergone a core decompression and allogenic fibular graft procedure for the treatment of osteonecrosis were retrospectively reviewed, compared with forty-one osteonecrotic hips in other thirty-five patients of total hip arthroplasty without previous allogenic fibular graft. Incision length, intraoperative and postoperative blood loss, blood transfusion rate, operative time, complication rate, positon of the components and postoperative Harris hip score were recorded and compared between the two groups. Results:The mean incision length of the study group was 13.23 cm (range, 12-15 cm), and in the control group it was 12.28 cm (10-15 cm; P=0.038). The mean intraoperative blood loss in the study group was 363.53 ml (range, 300-500 ml), and in the control group it was 356 ml (range, 200-600 ml; P=0.795). The mean postoperative drain volume in the study group was 499.41 ml(rage, 420-600 ml), and the control group was 487.6 ml(rage, 440-610 ml,P=0.479). The blood transfusion rate was 19.35% in the study group, and the control group was 25.71% (P=0.538). The mean operative time in the study group was 104.11 min (range, 70-130 min), and the control group was 94.4 min (range, 70-120 min; P=0.019). Complication rate of the study group was 3.23%, and in the control group it was 5.71% (P>0.05). The mean Harris hip score on the last follow-up day was 97.3(range, 92-100), and the it was 96.6(range, 92-100; P=0.340) in the control group. The mean anteversion angle in the study group was 44.06°(rage, 35°-48°), and it was 42.88° in the control group (37°-51°; P=0.270). The good position rate of stems of the study group was 67.65%, and in the control group it was 70.73% (P=0.773). Conclusion:Previous core decompression and allogenic fibular graft did not affect the outcome of total hip arthroplasty, but may increase operative time and incision length of total hip arthroplasty due to removing the residual graft.
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