A variety of nonvascularized bone grafting techniques have been proposed with varying degrees of success as treatment alternatives
for osteonecrosis of the femoral head. The success of these procedures may be enhanced using ancillary growth and differentiation
factors. We retrospectively reviewed 33 patients (39 hips) with osteonecrosis of the hip who had nonvascularized bone grafting
procedures with supplemental OP-1. We compared the outcomes in this cohort to similar patients treated nonoperatively or with
other nonvascularized bone grafting procedures. We used a trapdoor to make a window at the head-neck junction to remove necrotic
bone and packed the excavated area with autogenous cancellous bone graft, marrow, and OP-1. The minimum followup was 24 months
(mean, 36 months; range, 24–50 months). We performed no further surgery in 25 of 30 small- and medium-sized lesions (80%)
but did in two of nine large lesions. Hips with Ficat Stage II disease were not reoperated in 18 of 22 cases during the followup
periods. Our short-term results compare similarly to nonoperative treatment and other reports of nonvascularized bone grafting.
With the addition of ancillary growth factors, these procedures effectively reduce donor site morbidity and may defer joint
arthroplasty in selected patients.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.