Acetabular Anatomical Parameters in Patients With Idiopathic Osteonecrosis of the Femoral Head

Zeng, Junfeng; Zeng, Yi; Wu, Yuangang; Liu, Yuan; Xie, Huiqi; Shen, Bin

doi:10.1016/j.arth.2019.08.065

Cited by 18 publications

(27 citation statements)

References 25 publications

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“…The difference in the results could be due to the lack of a standardization of the ON patients into one specific stage group. The current study results are inconsistent with a recent study by Zeng et al,[ 13 ] as acetabular coverage in ON patients was found to be much greater than in the control individuals. A lower VA in the ON group in this study also indicates more acetabular coverage of the femoral head.…”

Section: Discussioncontrasting

confidence: 99%

“…A study of patients from East Asia also showed that less acetabular coverage could be associated with the development of femoral head ON. [ 13 ] In the current study, the CEA values were found to be higher and the SA values were lower in ON patients, compared to the control group, in contrast to the study by Zeng et al[ 13 ] Studies using CT and radiographs have suggested that malpositioning of the patient directly affects measurements of acetabular coverage of the femoral head. [ 11 , 21 , 22 ] Dandachli et al[ 23 ] reported that every 5 o increase in pelvic anterior tilt resulted in a decrease of up to 5 o in acetabular anteversion.…”

Section: Discussioncontrasting

confidence: 88%

“…In addition to known identifiable causes of ON, some cases (30%) are defined as idiopathic, as the exact pathology cannot be determined. [ 13 ] Acetabular VA has been blamed for many hip problems. [ 14 ] The acetabulum anteversion angle may slightly increase throughout skeletal maturation.…”

Section: Discussionmentioning

confidence: 99%

“…The ON group in this study only included Stage 2 patients, whereas Zeng et al[ 13 ] included both Stage 1 and Stage 2 patients. The difference in the results could be due to the lack of a standardization of the ON patients into one specific stage group.…”

Section: Discussionmentioning

confidence: 99%

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Is Stage 2 idiopathic osteonecrosis of the hip joint associated with version angles on imaging methods?

Günay

Özçelik

2021

Jt Dis Relat Surg

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Objectives In this study, we aimed to investigate whether anatomical variations of acetabulum were associated to idiopathic osteonecrosis (ON) of the femoral head. Patients and methods Between January 2014 and March 2020, a total of 46 patients (32 males, 14 females; mean age: 43 years; range, 18 to 66 years) who were diagnosed with unilateral or bilateral ON of the hip joint and 44 healthy age- and sex-matched controls (30 males, 14 females; mean age: 46 years; range, 18 to 79 years) with no signs of ON of the hip joint were retrospectively analyzed. For both groups, measurements were taken of the anatomic parameters, including the acetabular version angle (VA), the sharp angle (SA), and the center-edge angle (CEA) on anteroposterior pelvic radiographs and magnetic resonance imaging (MRI) scans. Results The mean VA of both hips was found to be significantly smaller in Group 1 than in Group 2 on both MRI and X-ray (14.9±4.1 and 14.4±3.1 vs. 17.3±3.9 and 18.0±3.7, respectively; p=0.004, p<0.001). The mean SA of both hips was found to be significantly smaller in Group 1 than in Group 2 on both MRI and X-ray (39.0±2.9 and 38.9±2.8 vs. 41.6±3.9 and 40.8±4.9, respectively; p=0.001, p=0.036). The mean CEA of both hips was found to be significantly larger in ON group than in control group on both MRI and X-ray (36.7±6.1 and 36.9±7.0 vs. 32.0±6.0 and 31.5±7.5, respectively; p<0.001, p=0.001). Conclusion Version angles were found to be smaller in patients with ON and more acetabular coverage was observed. Greater coverage of the acetabulum may indicate early collapses of the femoral head even in Stage 2 ON patients. The smaller version angles may be associated with ON.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Is Stage 2 idiopathic osteonecrosis of the hip joint associated with version angles on imaging methods?

Günay

Özçelik

2021

Jt Dis Relat Surg

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“…Similarly, some studies demonstrate that less acetabular coverage can increase intracapsular pressure, and excessive weight bearing suffered by the hip joint can contribute to the development of ONFH [23][24][25][26]. Junfeng Zeng et al [27] nd that less acetabular coverage may be associated with the development of ONFH in East Asian population, which is also a factor affecting the repair of ONFH. Thomas et al [28] retrospectively investigate ONFH patients who accept free vascularized bular grafting, and nd that patients with less acetabular coverage (a CE angle < 30 º) present a higher prevalence of failure of repair than patients with a CE angle > 30 º.…”

Section: Discussionmentioning

confidence: 99%

Ratio of the Medial Hip Joint Space as a Predictor for Collapse of the Femoral Head in Non-traumatic Osteonecrosis: A Retrospective Study and Finite Element Analysis

Lin

Yang

et al. 2020

Preprint

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Background: There has been no indicators that can effectively predict femoral head collapse in ONFH so far. The aim of this study is to retrospectively analyze the first-visit medial space ratio of the hip joint to evaluate its efficacy in predicting ONFH-induced collapse and impacts on the mechanical environment of necrotic femoral head.Methods: In this retrospective analysis for traditional Chinese medicine (TCM), non-traumatic osteonecrosis of femoral head (NONFH) patients from January 2010 to December 2016 were selected. The medial space ratio at their first visit and and collapse of the femoral head during the follow-up were recorded. Patients were divided into group A, B, C, D, and E according to the grading of the medial space ratio at the first visit. A total of 14 hip joint models with distinct medial space ratios were established. The maximum stress intensities of the cartilage, cortical bone and the necrotic area (N-unit area) of the femoral head in the models were quantitated using a finite element analysis.Results: One hundred twenty-eight patients (142 hips) were included in this study. The average follow-up time was 5.4±1.5 years.The Kaplan-Meier survival analysis showed that survival rates of the first-visit medial space ratios in group C and D were significantly higher (exceeding 45.76%) than that in group E (22.73%). There was no significant difference in the survival rates between group C and D (P > 0.05). The finite element analysis showed that in either the necrosis or non-necrosis group, the maximum stress in cartilage, cortical bone and the N-unit area of the femoral head increased with the medial space ratio decreasing. Conclusion: The medial space ratio shows clinical implications of predicting the collapse of NONFH except for assessing the relationship between the femoral head and the acetabulum. The stress concentrations of cartilage, cortical bone, and the necrotic area of the femoral head are enhanced with the medial space radio decreasing. Once the medial space ratio falls below 4 and continues to decline, the risk of necrotic collapse will become higher.

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Diagnostic value of necrotic lesion boundary in bone collapse of femoral head osteonecrosis

Fan

Zhang

Chen

et al. 2021

International Orthopaedics (SICOT)

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Purpose Our research developed a novel approach to quantitatively evaluate the boundary of necrotic lesions in osteonecrosis of the femoral head (ONFH) and to explore its diagnostic value in predicting bone collapse of the femoral head. Methods A retrospective cross-sectional study was conducted in our institution, and 146 hips (121 cases) identified as ONFH were recruited. The anterior and lateral boundaries of each enrolled subject were measured in standard anteroposterior (AP) view and frog-leg (FL) view of plain radiographic images, the intact rate of which was then calculated and presented as the anteroposterior view intact ratio (APIR) and frog-leg view intact ratio (FLIR), respectively. Univariate and multivariate logistic regression analyses were performed to identify risk factors for collapse. A receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity, specificity and cutoff value of the APIR and FLIR. A Kaplan-Meier (K-M) analysis was applied to calculate the survival rate of the femoral head, and bone collapse of the femoral head was regarded as the endpoint. Results Femoral head collapse was observed in 61 hips during the follow-up period. Patients with or without femoral head collapse were categorized into the collapse group and non-collapse group, respectively. The mean follow-up time was 3.7 years (2-9) for the collapse group and 7.7 years (5-20) for the non-collapse group. Univariate and multivariate logistic regression analysis and ROC analysis showed that APIR (< 25.61%) and FLIR (< 24.43%) were significantly associated with femoral head collapse. The K-M survival curves indicated that the overall survival rate of APIR (≥ 25.61%) was 94.8% at 7.5 years and 76.6% at 10 years, while that of FLIR (≥ 24.43%) was 87.3% at 7.5 years and ten years. ConclusionThe present study demonstrates that APIR and FLIR are of high diagnostic value in the early and middle stages of ONFH. APIR and FLIR can be used to predict the occurrence of femoral head collapse in patients with JIC classification types B and C1. The measurement of these two parameters in plain radiography images may contribute to the selection of a proper hip preservation strategy. Keywords Osteonecrosis of the femoral head • Collapse • Anteroposterior view intact ratio • Frog-leg view intact ratioYinuo Fan and Jiahao Zhang contributed equally to this work.

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Acetabular Anatomical Parameters in Patients With Idiopathic Osteonecrosis of the Femoral Head

Cited by 18 publications

References 25 publications

Is Stage 2 idiopathic osteonecrosis of the hip joint associated with version angles on imaging methods?

Is Stage 2 idiopathic osteonecrosis of the hip joint associated with version angles on imaging methods?

Ratio of the Medial Hip Joint Space as a Predictor for Collapse of the Femoral Head in Non-traumatic Osteonecrosis: A Retrospective Study and Finite Element Analysis

Diagnostic value of necrotic lesion boundary in bone collapse of femoral head osteonecrosis

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