Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 25893
OSTEONECROSIS OF THE FEMORAL HEAD: MRI FOR PREDICTION OF EARLY
COLLAPSE AFTER TREATMENT WITH CORE DECOMPRESSION AND
AUTOILIAC CANCELLOUS BONE GRAFT COMBINED WITH AN IMPLANTATION
OF AUTOLOGOUS BONE MARROW CELLS
Joon Soon KANG 1 , Kyoung Ho MOON 1 , Ye Yeon WON 2
1 Inha University Hospital, Orthopaedic Surg, Incheon (KOREA), 2 Ajou University,
Suwon (KOREA)
Purpose: To retrospectively evaluate whether the imaging finding of MRI has
prognostic value for prediction of early collapse osteonecrosis of the femoral head
(ONFH). Materials and Methods: Retrospective review was done for MRI of 62 hips in
55 patients with ONFH treated with autoiliac cancellous bone graft after core
decompression combined with a implantation of autologous bone marrow cells.
Following factors were analyzed: location, size, preoperative staging, the necrotic
angle of mid coronal image, bone marrow edema, signal intensity of necrotic area,
containment of necrotic area, presence of subchondral fracture, and presence of
collapse. Statistical analyses were conducted to evaluate the relationship between
those factors and early collapse within a year. Results: Twenty hips were developed
early collapse at the treatment site within a year. Only the necrotic angle of mid
coronal image was associated with early collapse (P = 0.005). The cut- off value of
necrotic angle of 100% of sensitivity (C.I: 58.9, 100) is more than 98 degrees and of
100% specificity (C.I: 78.0, 100) is more than 150 degrees. The early collapse within
a year was related to mid-term poor prognosis (P = 0.01). Conclusions: The necrotic
angle is strongly correlated with early collapse of ONFH after treatment with core
decompression and autoiliac cancellous bone graft combined with an implantation of
autologous bone marrow cells. The early collapse could be poor prognostic factor in
mid- term follow-up.
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