Physicians and health professionals with osteonecrosis of the femoral head: results of management with free vascularized fibular grafting.

Outcomes of free vascularized fibular grafting for the treatment of femoral head (FH) osteonecrosis between 1) physicians/health professionals and 2) a comparison group of the population at large was performed. Twenty-one healthcare providers (32 hips) were treated: 10 stage II, 7 stage III, and 15 stage IV were treated over a 13-year period. The control group consisted of 1257 hips: 221 with stage II, 220 with stage III, and 816 with stage IV. All patients were followed for a minimum of 2 years. The end point for failure was conversion to total hip arthroplasty. The physician group demonstrated a high degree of postoperative compliance. The conversion rate to total hip arthroplasty was significantly lower in the physician group (6.25%) compared to the control group (20.6%). Outstanding postoperative compliance appears to be related to favorable outcomes. Further evaluation of failure in both groups may help better understand FH osteonecrosis and improved patient outcomes.