Core Decompression Accompanied With Free Vascularized Fibular Graft And Iliac Graft Treating Osteonecrosis Of Femural Head:A Systematic Review

Objective: Make a systematic analysis on studies about core decompression accompanied with free vascularized fibular graft and with free vascularized iliac graft operations treating osteonecrosis of femural head(ONFH)to provide some guides for clinical works.Methods:Proper studies were selected from initiation to May 31 2020 in foreign and domestic databases like Pub Med,Embase,Web of science and CNKI,VIP Chinese Sci tech Journals,Wan Fang,Chinese Biomedical and so on.20 studies complying with inclusion standards were chosen.2 independent researchers checked and picked up the data,applying R3.6.0software Proption Cmbined Method and 95% confidence interval as the efficiency marker.Prognosis of the conversion rate of patients to total hip arthroplasty for ONFH patients were compared between free vascularized fibular graft and free vascularized iliac graft operations.Results:Random effects model was applied to make analysis for included studies,showing:1、compared with core decompression accompanied with free vascularized fibular graft operation,the conversion rate of patients treated by core decompression accompanied with free vascularized iliac graft operation was lower within 5years’ and5-10 years,follow-up(5years:FVFG+CD:Proption=0.16,95%CI=0.08-0.24,FVIG+CD:Proption=0.10,95%CI=0.05-0.16.5-10years:FVFG+CD:Proption=0.15,95%CI=0.05-0.24,FVIG+CD:Proption=0.06,95%CI=0.00-0.12).2 、 Compared with other recipient vessels,the rate conversion to THA for patients treated with core decompression accompanied with free vascularized graft,the second perforating branch of the deep femoral artery vein as the recipient vessels was lower.Conclusion:1、Compared with core decompression with free vascularized fibular graft operation,core decompression with free vascularized iliac graft might be more reasonable in treating ONFH patients.2、Second perforating branch of the deep femoral artery vein and ascending branch of the lateral circumflex femoral artery and vein may be the proper recipient vessels in core decompression accompanied with free vascularized graft.