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      Vascularized bone grafting fixed by biodegradable magnesium screw for treating osteonecrosis of the femoral head.

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          Abstract

          Hip-preserving surgery with vascularized bone graft implantation has been widely practiced in treating osteonecrosis of the femoral head (ONFH). However, the current approach presents a drawback, in which the implanted bone graft without screw fixation may slip or exhibit a certain degree of displacement postoperatively. This study was designed to investigate the application potential of biodegradable magnesium (Mg) screws for the fixation of vascularized bone graft in ONFH patients. Forty-eight patients were randomly divided into two groups: the Mg screw group (vascularized bone grafting fixed by Mg screws) and the control group (vascularized bone grafting without fixation). During 12 month follow-up period after surgery, treatment outcomes in patients were assessed by multiple imaging techniques including x-ray and computed tomography (CT) scanning as well as functional recovery Harris hip score (HHS). The temporal changes in serum levels of Mg, Ca, and P as well as in vivo degradation rate of Mg screws were determined. The absence of potential adverse effects induced by degradation products from Mg screws on surrounding bone tissue was validated via CT imaging analysis. HHS was significantly improved in the Mg screw group when compared to the control group. X-ray imaging analysis showed that the screw shape did not show significant alteration due to the diameter of Mg screws measured with approximate 25% reduction within 12 months post-surgically. The postoperative serum levels of Ca, Mg, and P, which are relevant for liver and kidney function, were all within normal physiological range in all patients of both groups. The use of biodegradable Mg screws may provide a promising bone graft-screw fixation route in treating ONFH and present considerable potential for orthopedic applications.

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          Author and article information

          Journal
          Biomaterials
          Biomaterials
          Elsevier BV
          1878-5905
          0142-9612
          Mar 2016
          : 81
          Affiliations
          [1 ] Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China. Electronic address: zhaodewei2000@163.com.
          [2 ] Department of Orthopedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.
          [3 ] Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: lingqin@cuhk.edu.hk.
          [4 ] Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China.
          [5 ] Dongguan Eontec Co., Ltd, Dongguan, China.
          [6 ] Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
          Article
          S0142-9612(15)00948-5
          10.1016/j.biomaterials.2015.11.038
          26724456
          ed99a628-31f2-481d-8486-036e85b09d7e
          History

          Biodegradability,Mg screw,Osteonecrosis of the femoral head,Vascularized bone graft

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