Clinical analysis of 23 cases of steroid-associated osteonecrosis of the femoral head with normal initial magnetic resonance imaging presentation

Zhao, Fengchao; Hu, Huai-Xia; Zheng, Xin; Cang, Dingwei; Liu, Xiaoyun; Zhang, Jianzhi; Guo, Kaijin

doi:10.1097/md.0000000000008834

Cited by 14 publications

(13 citation statements)

References 27 publications

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“…Due to reductions in imaging times, it will be possible to increase the number of additions for higher resolution images and obtain more images for another section. At the hip joint, MRI is often performed on both sides of patients being treated with steroid medication [ 12 , 13 ]. This reduced imaging time with SMS will be beneficial for acquiring high resolution images of both hip joints.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous multi-slice MR imaging of the hip at 3 T to reduce acquisition times and maintain image quality

Haraikawa

Suzuki

Inoue

et al. 2018

BMC Musculoskelet Disord

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BackgroundNewly developed simultaneous multi-slice (SMS) scans are now being introduced as a clinical application in neuroimaging. We examined the feasibility of SMS scans for joint imaging. The purpose of the present study was to prospectively compare the resolution and specific absorption rate (SAR) obtained using SMS to those of conventional methods in hip joint magnetic resonance imaging (MRI) and establish whether imaging times may be reduced using SMS in 3 T MRI and if image quality is affected.MethodsTwenty-one patients (4 men and 17 women, average age, 51.5 years, range: 22 to 76 years) with hip pain underwent MR examinations of the unilateral hip joint. Three board-certified radiologists independently and blindly evaluated the images obtained with and without SMS using window and level settings and magnification according to personal preferences. Individual SAR values were measured for each protocol. A Wilcoxon signed-rank test and a t-statistic test were used for statistical analyses. Signal-to-noise ratio (SNR) was also compared using a phantom.ResultsSMS imaging maintained equivalent image quality to conventional imaging for evaluating the morphology of the hip joint, and also reduced imaging times by approximately 40%. SMS images had significantly higher SAR values than conventional images. The rate of difference (SMS/conventional) in SNR ranged between 80 and 111%.ConclusionsBased on its significantly lower acquisition times and the maintenance of similar image quality to conventional imaging, SMS may be applied to morphological evaluations of hip joint disorders without significantly increasing SAR.

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Section: Discussionmentioning

confidence: 99%

Simultaneous multi-slice MR imaging of the hip at 3 T to reduce acquisition times and maintain image quality

Haraikawa

Suzuki

Inoue

et al. 2018

BMC Musculoskelet Disord

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“…We prospectively investigated 61 consecutive ONFH cases (69 hips) from patients who underwent bone grafting through a window in the femoral head, during the period from April 2009 to March 2012. The diagnostic criteria for ONFH as identified with magnetic resonance imaging (MRI) were a low signal band in the T1-weighted image and a high signal band in the corresponding STIR sequence [35] . The inclusion criteria were: (1) consent to participate in the present study with at least 6 years of follow-up; (2) age ≤ 50 years; (3) no joint-space narrowing; (4) discomfort (pain in the hip, groin, buttock, or knee) that interfered with daily activity; (5) lack of a neurological disorder that could affect the source of the patient's complaint; (6) no active connective tissue disease (e.g., rheumatoid arthritis, systemic lupus erythematosus).…”

Section: Methods Patientsmentioning

confidence: 99%

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Cheng

zhao

et al. 2020

Preprint

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Background The aim of the present study was to investigate clinical and radiological outcomes of autologous tricortical iliac graft through a window created at the femoral head, without suturing the opened articular cartilage to treat osteonecrosis of the femoral head (ONFH), called modified trapdoor procedures.Methods A total of 59 consecutive patients (67 hips; 36 males and 23 females) with ONFH were included in this study, which was conducted during the period from April 2009 to March 2012. Patient age ranged from 27 to 46 years old, with mean age of 36.3 years. Harris hip scores (HHS) were used to evaluate hip function pre- and postoperatively. Anteroposterior and frog-position X-rays and magnetic resonance imaging (MRI) were conducted to evaluate lesion location, size, and ARCO stage. Clinical failure was defined as score < 80 points or treatment by total hip arthroplasty(THA). Radiographic failure was defined as a > 3 mm of collapse in the hip. This group was retrospectively matched according to the ARCO stage, extent, location, etiology of the lesion, average age, gender, and preoperative Harris hip score to a group of 59 patients (67 hips) who underwent the“light bulb”approach during March 2007 to April 2009. Results Mean follow-up was 91.2 ± 13.6 months (range, 75–115 months). Mean HHS was 91.3 ± 4.5, compared with 83.1± 4.5 in the “light bulb” cohort at the 6 years follow-up examination (P < 0.001). At the 6 years follow-up, for modified trapdoor procedures, five hips (8.5%) were classified as clinical failure, and 3 hips underwent total hip arthroplasty; Seven hips were classified as (10.4%) radiographic failure.The clinical and radiographic failure of the hips treated with the modified trapdoor procedure was significantly lower than that of the hips treated with the “light bulb” procedure (p < 0.05). Survival of the joint was not significantly related to the location of the femoral head lesion between two groups, but there was better clinical and radiographic results in modified trapdoor procedures with Size-C and the ARCO stage III.Conclusion The study demonstrated superior medterm clinical results in ONFH with the use of autologous tricortical iliac block graft through a femoral head window, without suturing the opened articular cartilage. The results of this femoral head-preserving procedure in patients with postcollapse osteonecrosis and large lesion are superior to those of the “light bulb” procedure treatment.

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“…A total of 61 consecutive ONFH cases (69 hips) of patients who underwent bone grafting through a window in the femoral head between April 2009 and March 2012 were prospectively investigated. The diagnostic criteria for ONFH, as identified with magnetic resonance imaging (MRI) were a low signal band in the T1-weighted image and a high signal band in the corresponding STIR sequence [35] . The inclusion criteria were: (1) consent to participate in the present study with at least 6 years of followup; (2) age ≤ 50 years; (3) no joint-space narrowing; (4) discomfort (pain in the hip, groin, buttock, or knee) that interfered with daily activity; (5) lack of a neurological disorder that could affect the source of the patient's complaint; (6) no active connective tissue disease (e.g., rheumatoid arthritis, systemic lupus erythematosus); (7) ARCO stage II and III.…”

Section: Patientsmentioning

confidence: 99%

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Cheng

Zhao

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background The aim of the present study was to investigate clinical and radiological outcomes of autologous tricortical iliac graft through a window created at the femoral head, without suturing the opened articular cartilage to treat osteonecrosis of the femoral head (ONFH), called modified trapdoor procedures. Methods A total of 59 consecutive patients (67 hips; 36 males and 23 females) with ONFH were included in this study, which was conducted during the period from April 2009 to March 2012. Patient age ranged from 27 to 46 years old, with mean age of 36.3 years. Harris hip scores (HHS) were used to evaluate hip function pre- and postoperatively. Anteroposterior and frog-position X-rays and magnetic resonance imaging (MRI) were conducted to evaluate lesion location, size, and ARCO stage. Clinical failure was defined as score < 80 points or treatment by total hip arthroplasty(THA). Radiographic failure was defined as a > 3 mm of collapse in the hip. This group was retrospectively matched according to the ARCO stage, extent, location, etiology of the lesion, average age, gender, and preoperative Harris hip score to a group of 59 patients (67 hips) who underwent the“light bulb”approach during March 2007 to April 2009. Results Mean follow-up was 91.2 ± 13.6 months (range, 75–115 months). Mean HHS was 91.3 ± 4.5, compared with 83.1± 4.5 in the “light bulb” cohort at the 6 years follow-up examination ( P < 0.001). At the 6 years follow-up, for modified trapdoor procedures, five hips (8.5%) were classified as clinical failure, and 3 hips underwent total hip arthroplasty; Seven hips were classified as (10.4%) radiographic failure.The clinical and radiographic failure of the hips treated with the modified trapdoor procedure was significantly lower than that of the hips treated with the “light bulb” procedure (p < 0.05). Survival of the joint was not significantly related to the location of the femoral head lesion between two groups, but there was better clinical and radiographic results in modified trapdoor procedures with Size-C and the ARCO stage III. Conclusion The study demonstrated superior medterm clinical results in ONFH with the use of autologous tricortical iliac block graft through a femoral head window, without suturing the opened articular cartilage. The results of this femoral head-preserving procedure in patients with postcollapse osteonecrosis and large lesion are superior to those of the “light bulb” procedure treatment.

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Clinical analysis of 23 cases of steroid-associated osteonecrosis of the femoral head with normal initial magnetic resonance imaging presentation

Cited by 14 publications

References 27 publications

Simultaneous multi-slice MR imaging of the hip at 3 T to reduce acquisition times and maintain image quality

Simultaneous multi-slice MR imaging of the hip at 3 T to reduce acquisition times and maintain image quality

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

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