Prognostication of Osteonecrosis of the Femoral Head in Patients With Systemic Lupus Erythematosus by Magnetic Resonance Imaging

Sugano, Nobuhiko; Ohzono, Kenji; Masuhara, Kensaku; Takaoka, Kunio; Ono, Katsuhiko

doi:10.1097/00003086-199408000-00023

Cited by 96 publications

(67 citation statements)

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“…The location of the necrotic lesion also influences the rate of collapse [22,[24][25][26][27][28][29]. Sugano et al [28] originally proposed an MRI classification system that includes Types A, B, and C lesions; they reported Type A lesions are medial and rarely progress, Type B lesions are central and have intermediate progression, and Type C lesions have lateral involvement of the head and the worst prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Sugano et al [28] originally proposed an MRI classification system that includes Types A, B, and C lesions; they reported Type A lesions are medial and rarely progress, Type B lesions are central and have intermediate progression, and Type C lesions have lateral involvement of the head and the worst prognosis. However, Ito et al [13] reported the location of the necrotic lesion was not a major factor.…”

Section: Discussionmentioning

confidence: 99%

“…However, with the advent of MRI, it became easier to diagnose asymptomatic disease and to more accurately ascertain the extent, location, and stage of the necrotic lesion [2,17,28].…”

Section: Introductionmentioning

confidence: 99%

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Untreated Asymptomatic Hips in Patients With Osteonecrosis of the Femoral Head

Min

Song

Cho

et al. 2008

Clinical Orthopaedics &Amp; Related Research

108

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Because there is no consensus regarding the factors predicting femoral head collapse in asymptomatic osteonecrosis of the hip, we studied the risk factors for collapse. Between 1990 and 2000, we used MRI to confirm asymptomatic osteonecrosis of the femoral head in 81 patients (81 hips) whose other hip had nontraumatic symptomatic osteonecrosis and we monitored them prospectively. The minimum followup was 5 years (mean, 8.3 years; range, 5-16 years). At the latest followup, 31 hips (38%) were symptomatic and 26 hips (32%) had collapsed. The mean interval between diagnosis and collapse was 4.1 years. We observed no correlation between femoral head collapse and patients' age, gender, weight, presumed cause of osteonecrosis, or length of followup. With combined factors, only extent of large necrotic lesion (hazard ratio, 4.06; 95% confidence interval, 1.29-12.77) and location of Type C2 necrotic lesion (hazard ratio, 6.35; 95% confidence interval, 1.18-34.11) predicted collapse.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Untreated Asymptomatic Hips in Patients With Osteonecrosis of the Femoral Head

Min

Song

Cho

et al. 2008

Clinical Orthopaedics &Amp; Related Research

108

View full text Add to dashboard Cite

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“…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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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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“…The lesions with Grade c locations were further subdivided into Types c1 and c2 as described by Sugano et al [37,38]. Both types occupy greater than the medial 2 .…”

Section: Methodsmentioning

confidence: 99%

Transtrochanteric Rotational Osteotomy for Nontraumatic Osteonecrosis of the Femoral Head in Young Adults

Biswal

Hazra

Yun

et al. 2009

Clin Orthop Relat Res

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Transtrochanteric rotational osteotomy (TRO) is a controversial procedure with reported inconsistent results. We reviewed 50 patients (60 hips) who underwent this procedure for extensive osteonecrosis of the femoral head, focusing on varization to determine its effectiveness as a head-preserving procedure in young adults. The mean age of the patients was 28 years (range, 18-46 years). Using the Ficat-Arlet classification, 40 hips had Stage II and 20 hips had Stage III involvement. According to the classification system of Shimizu et al., the extent of the lesions were Grade C in 54 hips and Grade B in six hips; the location of the lesions were Grade c in 56 hips and Grade b in four hips. Minimum followup was 18 months (mean, 84 months; range, 18-156 months). The mean preoperative Harris hip score was 44.7 points (range, 32-62 points) which improved to an average postoperative score of 80.1 points (range, 44-100 points) at the latest followup. Forty-four hips showed no radiographic evidence of progression of collapse. Ten hips showed progressive collapse, seven hips showed progressive varus deformity, three hips had stress fractures of the femoral neck, and one hip had infection. We believe TRO with varization is worth attempting for extensive osteonecrosis of the femoral head in young adults, although failures and complications are not uncommon.

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Prognostication of Osteonecrosis of the Femoral Head in Patients With Systemic Lupus Erythematosus by Magnetic Resonance Imaging

Cited by 96 publications

References 0 publications

Untreated Asymptomatic Hips in Patients With Osteonecrosis of the Femoral Head

Untreated Asymptomatic Hips in Patients With Osteonecrosis of the Femoral Head

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

Transtrochanteric Rotational Osteotomy for Nontraumatic Osteonecrosis of the Femoral Head in Young Adults

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