Ae. Beris et Pn. Soucacos, Optimizing free fibular grafting in femoral head osteonecrosis: The Ioannina aiming device, CLIN ORTHOP, (386), 2001, pp. 64-70
Citations number
21
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
The extracapsular placement of a vascularized fibular graft in the subchond
ral region of the femoral head now is a widely accepted method for treating
patients with osteonecrosis of the femoral head, The effectiveness of the
fibular graft seems to be dependent on precise placement in a biologically
and anatomically relevant site within the femoral head, The current authors
present the Ioannina technique for application of a new computer-aided des
ign and computer-aided manufacturing process in the treatment of osteonecro
sis of the femoral head using free vascularized fibular transplantation. Th
e objective was to develop a computer-assisted design and manufacturing sys
tem for an accurate and easier approach to the necrotic area in the femoral
head. The Ioannina technique uses serial computed tomography scans of the
proximal femur to identify the configuration of the proximal femur, and the
size, location, and configuration of the lesion using a computer-aided des
ign and computer-aided manufacturing process. Optimal graft placement is de
termined and a guide wire canal is drilled into an patient-specific aiming
device. In this process, identification of the optimal graft location is re
lated to achieving that location surgically. The more arbitrary placement o
f the graft during conventional fibular graft surgery leads to accurate gra
ft placement in only 55% of the patients, whereas the use of the patient-sp
ecific Ioannina aiming device resulted in optimal graft placement in 89% of
the patients.