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- Title
Role of bone status in anterolateral portion of femoral head in the progression of osteonecrosis of the femoral head.
- Authors
Wei Qiushi; Fang Bin; Chen Zhenqi; He Mincong; Chen Xiaojun; Yang Fan; Zhang Qingwen; He Wei
- Abstract
BACKGROUND: Mechanical stress plays an important role in the progressive collapse in osteonecrosis of the femoral head. Therefore, the bone structure of weight-bearing area may be the risk factor for collapse. OBJECTIVE: To investigate the relationship between the bone preservation of weight-bearing area and collapse progression in necrotic femoral head. METHODS: Eighty-seven patients (102 hips) with ARCO stage II osteonecrosis of the femoral head, diagnosed by MRI, were enrolled. All patients underwent a natural progression. Collapse and bone involvement of the weight-bearing area were viewed by anteroposterior and frog-leg lateral radiographs. According to the location of the necrotic lesion on the anterolateral portion of the femoral head, the necrosis was divided into three types: type 1, the posteromedial and central portions; type 2, part of the anterolateral portion; type 3, the entire anterolateral portion. The collapse rate and the time to collapse in different types were assessed. RESULTS AND CONCLUSION: (1) All patients were followed up for 3-58 months. (2) Of the 60 hips with collapse, 46 (76.7%) hip collapse was identified on anteroposterior radiograph. On frog-leg lateral radiograph showing collapsed femoral head could be identified in 57 (95.0%) hips, which was significantly different (P < 0.01). (3) In all 102 hips, the collapse rate in type 3 osteonecrosis of the femoral head was significantly higher than that of type 2 osteonecrosis of the femoral head (P < 0.001), and the time to collapse was markedly shortened. None collapse occurred in all six hips with type I osteonecrosis of the femoral head during follow-up. (4) In summary, preservation of anterolateral portion is associated with potential collapse progression in necrotic femoral head.
- Subjects
MECHANICAL stress analysis; OSTEONECROSIS; FEMORAL nerve; TOTAL hip replacement; FEMUR neck
- Publication
Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu, 2019, Vol 23, Issue 16, p2516
- ISSN
2095-4344
- Publication type
Article
- DOI
10.3969/j.issn.2095-4344.1148