MRI appearance of femoral head osteonecrosis following core decompression and bone grafting

We used magnetic resonance imaging (MRI) to evaluate retrospectively 32 hips with avascular necrosis of the femoral head before and after core decompression and bone grafting. At a median follow-up time of 15 months, 4 of 9 large lesions had undergone femoral head collapse; 2 small lesions had decre...

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Bibliographic Details
Published in:Skeletal radiology 1991-01, Vol.20 (2), p.103-107
Main Authors: CHAN, T. W, DALINKA, M. K, STEINBERG, M. E, KRESSEL, H. Y
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Bone Marrow - pathology
Bone Marrow Diseases - pathology
Bone Transplantation
Diseases of the osteoarticular system
Edema - pathology
Female
Femur Head - pathology
Femur Head - surgery
Femur Head Necrosis - pathology
Femur Head Necrosis - surgery
Follow-Up Studies
Humans
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
Retrospective Studies
Risk Factors
Vascular bone diseases
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Summary:We used magnetic resonance imaging (MRI) to evaluate retrospectively 32 hips with avascular necrosis of the femoral head before and after core decompression and bone grafting. At a median follow-up time of 15 months, 4 of 9 large lesions had undergone femoral head collapse; 2 small lesions had decreased in size; and 14 small, 6 moderate, and 5 large lesions were unchanged. One hip with biopsy-proven avascular necrosis had diffuse marrow edema which resolved after surgery. The signal pattern within the lesions was analyzed in 17 hips. Fifteen lesions were unchanged, while one fat-like lesion became fibrous-like and one edema-like lesion resolved. Analysis of the femoral neck marrow signal in one patient revealed that premature fatty marrow conversion had reverted to hemopoietic marrow 2 years after surgery. Most lesions that appeared stable on MRI were clinically stable or improved. MRI can demonstrated changes in size and signal characteristics as well as femoral head collapse after core decompression and bone grafting. Changes in the surrounding marrow signal, including resolution of marrow edema and reconversion from fatty to hemopoietic marrow, can also be detected.
ISSN:0364-2348
1432-2161
DOI:10.1007/BF00193820