ISSN: 1859 - 2872
The relationship between osteonecrosis of the proximal femur identified by magnetic resonance imaging and histological examination
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Abstract
Summary
Objective: To correlate the magnetic resonance imaging (MRI) signal changes with the histology of bone samples from four regions of the proximal femur in patients undergoing THR for osteonecrosis of the femoral head. Subject and method: Ninety patients who had a unilateral total hip arthroplasty for treatment of symptomatic osteonecrosis of the femoral head were included in the study. Magnetic resonance imaging of hips was performed using a 3.0 T. We performed cancellous bone biopsies in the proximal part of the femur, and the femoral head intraoperatively and then examined the specimens histologically. Result: The proximal part of the femur had a grade of 2 or 3 according to the system of Humphreys et al, it was found to be relatively insensitive at identifying lesions below the head, with a sensitivity of only là 95.0% and the specificity was 91.2%. Only those patients with osteonecrosis of the femoral head secondary to steroid, who are known to be at high risk of early loosening, had MRI signal changes in the proximal part of the femur. Conclusion: This observation suggests that the MRI signal changes of the areas in the proximal femur may represent osteonecrotic lesions. The proximal femur is areas essential for the fixation of the femoral component. Pre-operative identification of such lesions in the proximal part of the femur may be important when considering total hip arthroplasty with short or long stem for osteonecrosis of the femoral head and follow post-operative.
Keywords: Osteonecrosis of the femoral head, magnetic resonance imaging, histology.
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References
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