Kyoung Tae Kim MD, Presenter: Nothing to Disclose

Yeo Ju Kim, Abstract Co-Author: Nothing to Disclose

Ju Won Lee MD, Abstract Co-Author: Nothing to Disclose

Sun Won Park, Abstract Co-Author: Nothing to Disclose

Mi Young Kim MD, Abstract Co-Author: Nothing to Disclose

Myung Kwan Lim MD, Abstract Co-Author: Nothing to Disclose

Won Hong Kim MD, Abstract Co-Author: Nothing to Disclose

Chang Hae Suh, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate whether the imaging finding of MRI has prognostic value for prediction of early collapse osteonecrosis of the femoral head (ONFH) after treatment with core decompression and autoiliac cancellous bone graft combined with an implantation of autologous bone marrow cells.

Retrospective review was done for MRI of 24 hips (right hip, 10; left hip, 8; both hips, 3) in 21 patients with ONFH treated with autoiliac cancellous bone graft after core decompression combined with an implantation of autologous bone marrow cells. Following factors were analyzed: location, size of the necrotic lesion, preoperative staging, the necrotic angle of mid coronal image, bone marrow edema, signal intensity of necrotic area. Statistical analyses were conducted to evaluate the relationship between those factors and early collapse within a year using Chi-square test, Mann-Whitney U test, and calculating receiver operating characteristic (ROC) analysis with differences in areas under the ROC curves.

Nine of 24 hips (37.5%) were developed early collapse at the treatment site within a year. The necrotic angle of mid coronal image, and the size of necrotic lesion were associated with early collapse (P < 0.05). The cut- off value of necrotic angle of 100% of sensitivity is more than 107.6 degrees and of 100% specificity is more than 124 degrees. The cut- off value of the size of necrotic lesion of 100% of sensitivity is more than 23.48% and of 100% specificity is more than 65.22 %.

The necrotic angle, and size of the necrotic lesion are 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.

 Even though early stage, the osteonecrosis with large necrotic angle and size should be avoid to treatment with core decompression and bone graft and an implantation of autologous bone marrow cells.

Kim, K, Kim, Y, Lee, J, Park, S, Kim, M, Lim, M, Kim, W, Suh, C, 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.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013751.html