Joint preserving surgery for @entity2530 and XXXX after chemotherapy in childhood.

@entity1 @entity981 @entity4713 @entity5 @entity158 @entity2530
BACKGROUND: As a complication of chemotherapy/corticosteroids for the treatment of @entity981 ( @entity981 ) and other @entity5 during childhood, avascular @entity2530 appears in up to 30 % of the @entity1 . Weight-bearing joints are involved in over 90 % of the cases. Total joint replacement is often necessary to restore function. Yet, endoprostheses in young @entity1 again bare the risk of later complications and the need for several revision surgeries. In this report, joint preserving surgical strategies will be discussed. @entity1 : Three hips and eleven knee joints in 8 @entity1 (4 male, 4 female) were operated on for symptomatic ON and/or @entity4713 ( @entity4713 ) after chemotherapy. Four of the @entity1 underwent surgery in more than one joint. The average age at the time of surgery was 18 years (range 14 - 26). The procedures included retrograde drilling (core decompression), bone grafting, implantation of collagen sponges with autologous bone marrow aspirate, osteochondral autograft transplantation and transplantation of periosteal flaps. Two hip joints underwent total joint replacement. Average follow up was 25 months. RESULTS: After an average follow up of 2 years, all @entity1 were satisfied with the functional results after the last follow up with @entity158 free walking for a minimum of 60 minutes. No night @entity158 was reported. One @entity1 complained about intermittent periods of dysaesthesia around the bone harvest area at the iliac crest. CONCLUSIONS: The aim of surgery for ON and @entity4713 after chemotherapy should be the reduction of @entity158 and preservation of the joint to bypass the risks of joint replacement in young @entity1 , although total joint replacement may become indicated in endstage degeneration of the involved joint.
