Prognostication of Nontraumatic Avascular Necrosis of the Femoral Head

Sugano, Nobuhiko; Takaoka, Kunio; Ohzono, Kenji; Matsui, Minoru; Masuhara, Kensaku; ONO, KEIRO

doi:10.1097/00003086-199406000-00019

Cited by 80 publications

(43 citation statements)

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“…Sugano et al [23] evaluated the percent area of necrotic lesions within the femoral head on anteroposterior and lateral radiographs and concluded that percent area on lateral radiographs was an appropriate indicator for the prediction of collapse. Koo et al [7] showed accurate prediction using an index calculated by multiplying the arc of the lesion in the mid-coronal MR image by that in the mid-sagittal MR image.…”

Section: Discussionmentioning

confidence: 99%

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Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head: a new three‐dimensional quantification using magnetic resonance imaging

Nishii

Sugano

Ohzono

et al. 2002

Journal Orthopaedic Research

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Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head: a new three-dimensional quantification using magnetic resonance imaging AbstractSize and location of a necrotic lesion are considered important factors predicting collapse of the femoral head in the early stages of osteonecrosis. However, few analytical studies have performed a three-dimensional quantification of lesions to clarify how these two morphological Factors are related to the occurrence of collapse. We evaluated the relevance of lesion size and location for prediction of collapse quantitatively using new three-dimensional indexes. Magnetic resonance (MR) imaging was performed in 65 hips in a consecutive series of 47 patients with osteonecrosis without radiological evidence of collapse. Lesion volume as well as latitude and longitude of the center of gravity of the lesion within the femoral head were calculated. Thirty-three hips developed radiological collapse, while in the remaining 32 hips collapse did not occur over 2 years. Multiple logistic regression analysis showed a significant relationship between lesion volume and radiological collapse. In 35 hips in which the lesion volume was less than 30% of the femoral head, only 9 collapsed. In comparison with non-collapsed hips, collapsed hips had a significantly higher combined value for latitude and longitude of the lesion, corresponding to the anterosuperior portion of the femoral head. Quantitative analysis o f lesion morphology dcmonstrated that lesion volume is strongly correlated with risk of collapse, and that lesion location is an important prognostic indicator of collapse in small necrotic lesions.

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Section: Discussionmentioning

confidence: 99%

“…Among various related factors, many authors have noted the influence of size and location of necrotic lesions on the risk of collapse [4,6,7,16,18,20,23,24]. The morphological status of a necrotic lesion, including its size and location, has been quantified using radiographs o r magnetic resonance (MR) imaging in one plane or a combination of two planes.…”

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confidence: 99%

Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head: a new three‐dimensional quantification using magnetic resonance imaging

Nishii

Sugano

Ohzono

et al. 2002

Journal Orthopaedic Research

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100

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“…While there is no universal agreement in classification systems, it is well established that the prognosis is directly related to several factors: the extent of the osteonecrotic lesion [48,[62][63][64][65], the presence of a subchondral fracture [66,67], and the location of the lesion [68,69]. Most classification systems are based upon these prognostic factors.…”

Section: Prognostic Factorsmentioning

confidence: 99%

Osteonecrosis of the femoral head: diagnosis and classification systems

Choi

Steinberg

Cheng

2015

Curr Rev Musculoskelet Med

103

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Osteonecrosis of femoral head is a rare but disabling condition that usually results in progressive femoral head collapse and secondary arthritis necessitating total hip arthroplasty if not treated appropriately in early stages. However, early diagnosis is challenging as the onset of disease is insidious and the symptoms and signs are usually minimal and nonspecific until it becomes advanced. Of several diagnostic modalities, magnetic resonance imaging (MRI) is considered the imaging method of choice with the highest sensitivity and specificity, while detection of potential risk factors is very important as well. Many investigators have developed several different classification systems; however, there still is controversy regarding the optimal classification system. Diagnostic methods and the evolution of different classification systems will be reviewed in this paper.

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“…Prevalence of bilateral involvement has been reported to be as much as 78% [13,26]. An unusual situation occurs when the patient presents with ONFH on one side that may require HA (Stage IV according to Steinberg et al [25] with greater than 2 mm collapse), whereas the other less symptomatic or asymptomatic side also has ONFH that may be saved via a femoral head-preserving procedure (B Stage III).…”

Section: Introductionmentioning

confidence: 99%