Evaluation of the hemodynamics of the femoral head compared with the ilium, femoral neck and femoral intertrochanteric region in healthy adults: Measurement with positron emission tomography (PET)

Abstract

The present study demonstrated that the femoral head is in a hypoemic state as compared with other osseous tissue, indicating that even the slightest exacerbation of hemodynamics in the femoral head can trigger an ischemic condition culminating in ONF.

Prediction of Avascular Necrosis of the Femoral Head by Measuring Intramedullary Oxygen Tension After Femoral Neck Fracture

“…2 Nakamura et al evaluated the hemodynamics of the femoral head by using PET and concluded that the femoral head is in an ischemic state compared with the ilium, femoral neck, and intertrochanteric regions. 3 In conclusion, we believe that this method for measuring intramedullary oxygen tension is simpler and less invasive than other currently used methods and has the possibility for intraoperatively identifying a risk group that can develop a late segmental collapse of the femoral head secondary to avasucular necrosis. …”

“…[1][2][3][4] Hirata et al reported that dynamic MRI was useful for prediction of union after femoral neck fracture. 1 Sugamoto et al reported that the laser Doppler device was useful to measure hemodynamics in the femoral neck fractures and Garden stage III fractures should be subdivided into 2 groups according to their hemodynamics.…”

“…If arterial damage is the main cause of posttraumatic avascular necrosis of the femoral head, then intramedullary oxygen tension in the femoral head and neck should be related to the occurrence of posttraumatic avascular necrosis and any subsequent late segmental collapse. Many methods have been reported for evaluating the hemodynamic status of the proximal femur [1][2][3][4][5] ; however, intramedullary oxygen tension, which is theoretically directly related to survival of cells, has not been well studied. 6,7 Kiaer et al reported that the subchondral oxygen tension in the diseased hip was significantly lower than the oxygen tension in the normal hip and that the oxygen tension was lower in bone with histological necrosis than in bone without that finding.…”

The management of ununited fractures of the femoral neck using internal fixation and muscle pedicle periosteal grafting

“…Haemodynamic studies using positron emission tomography have shown that the femoral head is always in a hypovolaemic state compared with other osseous tissue. 34 Both the extra-and the intraosseous blood supplies of the femoral head are susceptible to injury in patients with a femoral neck fracture. Although the major intraosseous vessels are nearly always damaged, injury to the extraosseous vessels is proportional to the amount of displacement of the fracture.…”

Osteonecrosis in Children After Therapy for Malignancy

“…Metabolic activity in sites of osteonecrosis has been detected during 18 F-FDG PET or PET/CT performed for disease staging; these sites of osteonecrosis may mimic metastatic lesions [56]. Preliminary investigations in adults have found FDG PET to be a sensitive imaging method for detecting osteonecrosis [57][58][59] and in assessing perfusion of the femoral head [57,58]. However, prospective reports in pediatric cases are lacking.…”