Chinese Experts' Consensus on the Diagnosis and Treatment of Osteonecrosis of the Femoral Head in Adults

Zhao, Dewei; Hu, Yongcheng

doi:10.1111/j.1757-7861.2012.00192.x

Cited by 53 publications

(55 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors concluded that PET scans may have more diagnostic value in identifying early stage (Steinberg I) ON than other imaging modalities. Despite studies showing the benefits of PET scans, its use in the diagnosis of ON is not common practice due to its high cost and time-consuming nature [6]. Further studies are needed highlighting the advantages of PET scans in ON to justify the disadvantages of this imaging modality.…”

Section: New Technologies Positron Emission Tomographymentioning

confidence: 99%

“…A band-like lesion showing a low intensity signal on T1-weighted images is usually pathognomonic for this disease [3,6,14,24,28,33]. In addition to the pathognomonic band-like lesion, bone marrow edema has been discussed as a potential early finding indicative of ischemia.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…Hence, they concluded that although bone scanning may be useful as a screening tool, it shows the least utility in the earliest stages of the disease. In summary, the utility of bone scanning in staging and diagnosing ON remains an area of investigation; however, routine bone scanning is not recommended [6,47].…”

Section: -Technetium Bone Scanmentioning

confidence: 99%

“…The first classification system of ON based on plain radiographs acknowledged that many small areas of osteonecrosis are not found using this modality [6]. Multiple studies and reviews have confirmed that plain radiographs are highly specific for advanced disease but exhibit very low sensitivity for the earliest stages of the disease [12,14].…”

Section: Introductionmentioning

confidence: 99%

“…Plain radiographs are commonly obtained, but magnetic resonance imaging (MRI) is now considered the gold standard of diagnosis as it is highly specific (>99 %) and sensitive for the earliest stages of ON [3, 4••, 5]. Many recent studies have attempted to provide an improvement on the diagnostic abilities of plain radiographs and MRI with an emphasis on prognosis [6][7][8][9][10]. In addition, more recent literature has attempted to incorporate alternative imaging technologies that may improve upon the diagnostic evaluation of ON [6].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Imaging evaluation of patients with osteonecrosis of the femoral head

Pierce

Jauregui

Cherian

et al. 2015

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Imaging modalities for the diagnosis of osteonecrosis (ON) of the femoral head have been studied extensively, but there have been few reports strictly addressing radiographic evaluation. The purpose of this report is to examine the use and role of (1) plain radiographs, (2) magnetic resonance imaging (MRI), (3) computerized tomography (CT), (4) bone scanning, and (5) positron emission topography (PET) for the diagnostic evaluation of ON. Plain radiographs are a mainstay in diagnosis but have very low sensitivity for early ON. MRI is the gold standard for diagnostic evaluation but may not identify subchondral fractures on collapse as well as CT scan or tomogram. Bone scanning should not be used for diagnosis due to its low sensitivity. PET scanning does not have a definitive role in diagnosis yet. Future research should focus on the role of new imaging technologies in evaluation.

show abstract

Section: New Technologies Positron Emission Tomographymentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: -Technetium Bone Scanmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Imaging evaluation of patients with osteonecrosis of the femoral head

Pierce

Jauregui

Cherian

et al. 2015

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

show abstract

Preclinical models for studying corticosteroid‐induced osteonecrosis of the femoral head

Tsubosaka,

Maruyama,

Lui

et al. 2023

J Biomed Mater Res

View full text Add to dashboard Cite

Nontraumatic osteonecrosis of the femoral head (ONFH) is a refractory condition that commonly results in femoral head collapse and degenerative arthritis of the hip. In the early stages, surgical procedures for hip preservation, including core decompression (CD), have been developed to prevent progressive collapse of the femoral head. Optimization of bone regeneration and biological augmentation may further enhance the therapeutic efficacy of CD for ONFH. Thus, combining CD with cell‐based therapy has recently been proposed. In fact, patients treated with cell‐based therapy using autologous bone marrow concentrate demonstrate improved survivorship of the femoral head, compared with conventional CD alone. Preclinical research studies to investigate adjunctive therapies for CD often utilize the rabbit model of corticosteroid‐induced ONFH. Mesenchymal stem cells (MSCs) are known to promote osteogenesis and angiogenesis, and decrease inflammation in bone. Local drug delivery systems have the potential to achieve targeted therapeutic effects by precisely controlling the drug release rate. Scaffolds can provide an osteoconductive structural framework to facilitate the repair of osteonecrotic bone tissue. We focused on the combination of both cell‐based and scaffold‐based therapies for bone tissue regeneration in ONFH. We hypothesized that combining CD and osteoconductive scaffolds would provide mechanical strength and structural cell guidance; and that combining CD and genetically modified (GM) MSCs to express relevant cytokines, chemokines, and growth factors would promote bone tissue repair. We developed GM MSCs that overexpress the anti‐inflammatory, pro‐reconstructive cytokines platelet‐derived growth factor‐BB to provide MSCs with additional benefits and investigated the efficacy of combinations of these GM MSCs and scaffolds for treatment of ONFH in skeletally mature male New Zealand white rabbits. In the future, the long‐term safety, efficacy, durability, and cost‐effectiveness of these and other biological and mechanical treatments must be demonstrated for the patients affected by ONFH.

show abstract

Analysis of MR Signs to Distinguish Between ARCO Stages 2 and 3A in Osteonecrosis of the Femoral Head

Shi

Luo

Sun

et al. 2021

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background: MRI is the most effective diagnostic tool of osteonecrosis of the femoral head (ONFH), especially for early diagnosis, but its detection of subchondral or cortical fractures is less accurate than CT. Therefore, it is difficult to accurately stage ONFH in the peri-collapse period by MRI. Purpose: To improve the accuracy of MR for distinguishing between Association Research Circulation Osseous (ARCO) stages 2 and 3A in ONFH. Study Type: Retrospective. Subjects: One hundred and fifty five cases of ARCO stage 2/3A of ONFH underwent MR examinations, M/F = 72/83. CT was used as reference standard for collapse, which was decided by an orthopedist and a radiologist in consultation. Field Strength/Sequence: 3 T/axial and coronal T 1 -weighted Turbo Spin Echo (T 1 W TSE) sequence, axial T 2 -weighted fat-saturated (T 2 W FS) TSE sequence, and coronal proton density-weighted imaging (PDWI)-FS-Dixon fat/water image. Assessment: Five potential MR signs (the maximum width of the necrotic-viable interface, bone marrow edema (BME), irregular articular surface of the femoral head, T 2 heterogeneous high signal, and the absence of a necrotic-viable interface with the morphology of closed loop) were evaluated blindly by five radiologists independently and the total scores of different combinations of MR signs were calculated. Statistical Tests: Mann-Whitney U test and Chi-square test were used to evaluate age, gender, and MR signs differences between the two groups. ROC curve was used to access the distinguishing value of MR signs. The consistency of the five radiologists was analyzed by intraclass correlation coefficient. Results: The area under the curve of the combined MR signs 2 for distinguishing between ARCO stages 2 and 3A was the greatest (0.967), sensitivity and specificity were 100.00% and 88.71% respectively, and greater than 1 was the threshold. Data Conclusion: Combined MR signs 2 has great values in distinguishing between ARCO stages 2 and 3A in ONFH, thus helping clinical therapy. Level of Evidence: 4 Technical Efficacy: Stage 2

show abstract

Chinese Experts' Consensus on the Diagnosis and Treatment of Osteonecrosis of the Femoral Head in Adults

Cited by 53 publications

References 19 publications

Imaging evaluation of patients with osteonecrosis of the femoral head

Imaging evaluation of patients with osteonecrosis of the femoral head

Preclinical models for studying corticosteroid‐induced osteonecrosis of the femoral head

Analysis of MR Signs to Distinguish Between ARCO Stages 2 and 3A in Osteonecrosis of the Femoral Head

Contact Info

Product

Resources

About