Outcomes of Osteonecrosis of Femur Head by Core Decompression and Tensor Fascia Lata Based Muscle Pedicle Bone Graft

Purpose: Osteonecrosis of femoral head (ONFH) is the major cause of musculoskeletal disability. Core decompression (CD) is the most widely used strategy for the management of ONFH but it lacks the ability to increase the vascularization around the necrotic femoral head. So the purpose of the study was to evaluate the outcome of CD with tensor fascia lata muscle pedicle bone graft in ONFH patients.

Methods: This prospective study was conducted on 26 ONFH patients. Core decompression with TFL muscle pedicle grafting methods was used in all the patients. The outcome of the technique was evaluated using Harris hip score.

Results: In this study, the major risk factor ONFH was alcohol intake followed by chronic steroid use. Majority of the patients (57.69%) were in stage III ONFH. The Harris Hip Score was excellent in 14 hips (53.846%), fair in 2 hips (7.692%) and poor in 1 hip (3.84%) respectively. There was a significant increase in post operative Harris hip score as compared to preoperative (86.6 ± 8.0 vs 63.7 ± 6.7).

Conclusion: Tensor fascia lata muscle pedicle grafting along with core decompression is a reliable technique for pain reduction and improved vascularization in necrotic femoral head.