Muscle Pedicle Graft in Avascular Necrosis Femoral Head
Muscle pedicle graft has been advanced as a modality of treatment
in Ficat et al1 Grade1 and Grade 2 avascular necrosis of the head of the femur.
What effect it has on the vasculature of the head has been a matter of speculation.
This surgery has been performed at our institution since 1983, although there is yet to
be a validated method to quantify the blood supply to the diseased head.
The one investigation which seemed to hold out promise was the Tc-99 bone scan.
A paper on perfusion studies by Urologists to study renal perfusion
in transplanted kidneys drew attention.
This ratio formed the basis of comparison in the pre-operative and all
post-operative bone scans of each patient.
In pre-operative scan, H1 was the sum of the pixel count in both the views-anterior and
posterior. V1 was the sum of pixel count of both the vertebral control areas
in the anterior and posterior readings.
X1 was the ratio of H1/V1. Similarly, post-operatively the same ratios were
taken, and designated as X2=H2/V2.
A total of 66 hips in 38 patients have been studied so far. Table 3 shows the side involved.
Figure 3 and 4 shows the X2/X1 ratio after six months of surgery
Orthop Res Traumatol Open J. 2017;2(1): 29-34. doi: 10.17140/ORTOJ-2-108
