Early-stage avascular necrosis of the femoral head: MR imaging for prognosis in 31 cases with at least 2 years of follow-up.

Lafforgue, P.; E, Dahan; Chagnaud, Christophe; Schiano, A; Kasbarian, M; Acquaviva, P

doi:10.1148/radiology.187.1.8451413

Cited by 121 publications

(56 citation statements)

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“…Therefore we have tried to assess the prognostic factors for core decompression. Most authors agree that the extent of the necrotic area is closely related to the clinical outcome of osteonecrosis [8,10,13,14,16,18]. However, different methods have been used for measurement of the extent of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Failure after core decompression in osteonecrosis of the femoral head

Yoon¹,

Song²,

Rowe³

et al. 2001

International Orthopaedics

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In a retrospective study of 39 hips with osteonecrosis of the femoral head treated with core decompression we evaluated the extent of the necrotic area, the Ficat stage and the location of the lesion. The extent of the necrotic lesion was classified into three categories: mild, less than 15%; moderate, 15-30%; and severe, more than 30%. In 14 mild cases core decompression failed in 2, whereas there were 4 failures out of 7 moderate cases and 16 failures out of 19 severe cases. The extent and location of the necrotic portion as well as the Ficat stage can be used as predictors for the result of core decompression in osteonecrosis of the femoral head.Résumé Dans une étude rétrospective de 39 hanches avec osteonécrose de la tête fémorale traitée avec dé-compression nous avons évalué l'ampleur de la région de la nécrose, les Ficat stage et l'emplacement de la lésion. L'ampleur de la lésion de la nécrose a été classée dans trois catégories: doux, plus petit que 15%; modéré, 15-30%; et sévère, plus que 30%. Dans 14 décompres-sions du coeur des cas doux manqués en 2 alors qu'il y avait 4 échecs hors de 7 cas du modéré et 16 échecs hors de 19 cas sévères. L'ampleur et emplacement de la portion de la nécrose aussi bien que l'étape Ficat peut être utilisée comme prophètes pour le résultat de décompres-sion du coeur dans osteonécrose de la tête fémorale.

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Section: Discussionmentioning

confidence: 99%

Failure after core decompression in osteonecrosis of the femoral head

Yoon¹,

Song²,

Rowe³

et al. 2001

International Orthopaedics

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“…In a systematic literature review, Marker et al [12] evaluated the clinical and radiographic outcomes of core decompression in surgeries done before [13][14][15][16][17][18][19][20][21][22] and after 1992 [1,2,10,[23][24][25][26][27][28][29][30][31] (n=1268 and 1337 hips, respectively). The authors demonstrated that in procedures performed before 1992, 41 % of hips required additional surgery after a mean follow-up of 65 months (range, 3 to 216 months).…”

Section: Overall Outcomes Of Traditional Core Decompressionmentioning

confidence: 99%

A current review of core decompression in the treatment of osteonecrosis of the femoral head

Pierce

Jauregui

Elmallah

et al. 2015

Curr Rev Musculoskelet Med

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The review describes the following: (1) how traditional core decompression is performed, (2) adjunctive treatments, (3) multiple percutaneous drilling technique, and (4) the overall outcomes of these procedures. Core decompression has optimal outcomes when used in the earliest, precollapse disease stages. More recent studies have reported excellent outcomes with percutaneous drilling. Furthermore, adjunct treatment methods combining core decompression with growth factors, bone morphogenic proteins, stem cells, and bone grafting have demonstrated positive results; however, larger randomized trial is needed to evaluate their overall efficacy.

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“…By rotating the femoral head, the diseased weight-bearing surface is reestablished by repositioning the femoral head, reducing the forces on the diseased part to prevent collapse and allow healing [16,28]. Sugioka [28] reported successful outcomes with rotation angles of 55°-70°in anterior rotated TRO and Atsumi and Kuroki [2] reported successful outcomes with rotation angles of up to 180°when performing a TRO with posterior rotation.…”

Section: Discussionmentioning

confidence: 99%

Modified Transtrochanteric Rotational Osteotomy for Femoral Head Osteonecrosis

Yoon

Abbas

Hur

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Osteonecrosis of the femoral head is a disabling condition affecting young patients and treatment of the disease in these patients is variable. We retrospectively reviewed 39 patients (43 hips) in whom a modified transtrochanteric rotational osteotomy was performed for osteonecrosis. The minimum followup was 24 months (mean, 36.6 months; range, 24-52 months). The mean patient age was 34.3 years (range, 20-51 years). Based on the ARCO classification, 17 hips were classified as Stage II and 26 as Stage III. We performed rotational osteotomy alone in 15 cases, in combination with simple bone grafting in three, and in combination with muscle-pedicle-bone grafting in 25. Sixteen of 17 ARCO Stage II cases and 24 of 26 ARCO Stage III cases had no progression of collapse or lesion size; three hips progressively collapsed. Of the 40 hips without progression the Harris hip score improved from a mean 70 to 92 points at final followup, as did the range of motion of the hip. Modified transtrochanteric rotational osteotomy is an effective method for delaying the progression of collapse in the treatment of selected cases of osteonecrosis of the femoral head.

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Early-stage avascular necrosis of the femoral head: MR imaging for prognosis in 31 cases with at least 2 years of follow-up.

Cited by 121 publications

References 0 publications

Failure after core decompression in osteonecrosis of the femoral head

Failure after core decompression in osteonecrosis of the femoral head

A current review of core decompression in the treatment of osteonecrosis of the femoral head

Modified Transtrochanteric Rotational Osteotomy for Femoral Head Osteonecrosis

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