Role of bone status in anterolateral portion of femoral head in the progression of osteonecrosis of the femoral head
Wei Qiushi
Fang Bin
Chen Zhenqiu
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.
Keywords：osteonecrosis of the femoral headbone structureweight-bearing areacollapsefrog-leg lateral radiographsimagingbone preservationthe National Natural Science Foundation of China
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 2516-2522 )