Repair in osteonecrosis of the femoral head: MR imaging features at long-term follow-up

Aims The aim of this study was to assess the prognostic value of the modified three-group Stulberg classification, which is based on the sphericity of the femoral head, in patients with Perthes’ disease. Methods A total of 88 patients were followed from the time of diagnosis until a mean follow-up of 21 years. Anteroposterior pelvic and frog-leg lateral radiographs were obtained at diagnosis and at follow-up of one, five, and 21 years. At the five- and 21-year follow-up, the femoral heads were classified using a modified three-group Stulberg classification (round, ovoid, or flat femoral head). Further radiological endpoints at long-term follow-up were osteoarthritis (OA) of the hip and the requirement for total hip arthroplasty (THA). Results There were 71 males (81%) and 17 females. A total of 13 patients had bilateral Perthes’ disease; thus 101 hips were analyzed. At five-year follow-up, 37 hips were round, 38 ovoid, and 26 flat. At that time, 66 hips (65%) were healed and 91 (90%) were skeletally immature. At long-term follow-up, when the mean age of the patients was 28 years (24 to 34), 20 hips had an unsatisfactory outcome (seven had OA and 13 had required THA). There was a strongly significant association between the modified Stulberg classification applied atfive-year follow-up and an unsatisfactory outcome at long-term follow-up (p < 0.001). Between the five- and 21-year follow-up, 67 hips (76%) stayed in their respective modified Stulberg group, indicating a strongly significant association between the Stulberg classifications at these follow-ups (p < 0.001). Conclusion The modified Stulberg classification is a strong predictor of long-term radiological outcome in patients with Perthes’ disease. It can be applied at the healing stage, which is usually reached five years after the diagnosis is made and before skeletal maturity. Cite this article: Bone Joint J 2021;103-B(12):1815–1820.

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Long-Term Follow-up of Residual Mediastinal Masses in Treated Hodgkin's Disease Using MR Imaging

Acta Radiologica ◽

10.1177/02841851960371p168 ◽

1996 ◽

Vol 37 (1P1) ◽

pp. 323-326 ◽

Cited By ~ 5

Author(s):

R. Nyman ◽

G. Forsgren ◽

B. Glimelius

Keyword(s):

Mr Imaging ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Mediastinal Masses ◽

Long Term Follow Up ◽

Residual Masses ◽

The Masses ◽

Post Therapy

Purpose: Long-term follow-up of residual mediastinal masses in treated Hodgkin's disease using MR imaging. Material and Methods: Ten patients, with substantial residual mediastinal masses of low signal intensity (SI) in the T2-weighted image (T2WI), were reinvestigated with MR 19–79 months after completing treatment of Hodgkin's disease. All patients were in complete remission. Results: During the follow-up period, the masses had decreased in size by 0–95% (median 67%) as compared to their initial post-therapy size. The SI continued to be low in the T2WI and was unaffected by the degree of size reduction. Conclusion: It is speculated that these mainly fibrotic residual masses undergo slow degradation of the fibrotic part and/or resorption of remaining inflammatory tissue. It is important to understand the natural, long-term MR imaging changes of these residual masses in order more easily to recognize tumour recurrence or other pathologic conditions.

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Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting. A long-term follow-up study of one hundred and three hips.

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-199505000-00004 ◽

1995 ◽

Vol 77 (5) ◽

pp. 681-694 ◽

Cited By ~ 298

Author(s):

J R Urbaniak ◽

P G Coogan ◽

E B Gunneson ◽

J A Nunley

Keyword(s):

Femoral Head ◽

Follow Up Study ◽

Long Term Follow Up ◽

Fibular Grafting ◽

Free Vascularized Fibular Grafting

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Comments on "Semipermanent Filler Treatment of HIV-Positive Patients With Facial Lipoatrophy: Long-Term Follow-up Evaluating MR Imaging and Quality of Life"

Aesthetic Surgery Journal ◽

10.1177/1090820x14533699 ◽

2014 ◽

Vol 34 (6) ◽

pp. NP35-NP36 ◽

Cited By ~ 1

Author(s):

R. Rauso ◽

G. Colella ◽

G. Tartaro

Keyword(s):

Quality Of Life ◽

Mr Imaging ◽

Hiv Positive ◽

Long Term Follow Up ◽

Facial Lipoatrophy

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Retrospective Long-Term Follow-Up Survival Analysis of the Management of Osteonecrosis of the Femoral Head With Pedicled Vascularized Iliac Bone Graft Transfer

The Journal of Arthroplasty ◽

10.1016/j.arth.2019.03.069 ◽

2019 ◽

Vol 34 (8) ◽

pp. 1585-1592 ◽

Cited By ~ 2

Author(s):

Hui Xie ◽

Benjie Wang ◽

Simiao Tian ◽

Boyi Liu ◽

Kairong Qin ◽

...

Keyword(s):

Survival Analysis ◽

Femoral Head ◽

Bone Graft ◽

Iliac Bone ◽

Iliac Bone Graft ◽

Long Term Follow Up

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Free vascularized fibular graft for treatment of pathological femoral neck fracture and osteonecrosis of the femoral head: A case report with a long-term follow-up

Microsurgery ◽

10.1002/micr.20598 ◽

2008 ◽

Vol 29 (3) ◽

pp. 240-243 ◽

Cited By ~ 6

Author(s):

Alexandros E. Beris ◽

Marios G. Lykissas ◽

Alexandros Payatakes ◽

Vasileios A. Kontogeorgakos ◽

Alexandros Mavrodontidis ◽

...

Keyword(s):

Case Report ◽

Femoral Head ◽

Femoral Neck ◽

Fibular Graft ◽

Vascularized Fibular Graft ◽

Long Term Follow Up ◽

Neck Fracture ◽

Free Vascularized Fibular Graft

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Long-term Survival and Clinical Outcomes of Non-vascularized Autologous and Allogeneic Fibular Grafts are Comparable for Treating Osteonecrosis of the Femoral Head

10.21203/rs.3.rs-101438/v1 ◽

2020 ◽

Author(s):

Ke Jie ◽

Wenjun Feng ◽

Feilong Li ◽

Keliang Wu ◽

Jinlun Chen ◽

...

Keyword(s):

Survival Rate ◽

Femoral Head ◽

Clinical Outcomes ◽

Harris Hip Score ◽

Fibular Graft ◽

Vas Score ◽

Long Term Follow Up ◽

Group A

Abstract Background Osteonecrosis of the femoral head (ONFH) is a disabling disease, which often involves young patents. Recently, various hip-preserving surgeries were recommended to delay total hip arthroplasty (THA).Questions/purposes This study aimed to compare clinical outcomes and survival rate in the long-term follow-up between core decompression combined with a non-vascularized autologous fibular graft (group A) and an allogeneic fibular graft (group B) for the treatment of ONFH.Patients and Methods We retrospectively evaluated 117 patients (153 hips) with ONFH (Association Research Circulation Osseous [ARCO] stages IIa to IIIc) who underwent the above-mentioned hip-preserving surgeries between January 2003 and June 2012. The mean (range) follow-up times (years) were 12.9 (7–16) and 9.3 (6–16) in groups A and B, respectively. Clinical outcomes were assessed using the Harris hip score (HHS), visual analog scale (VAS) score, forgotten joint score (FJS). A survival analysis was performed using the Kaplan-Meier method. The end point was THA.Results Groups A and B showed postoperative improvements, respectively, in HHS from 65±7.2 to 80.3±14.5 and from 66±5.9 to 82.4±13.6 (p<0.05), and in VAS score from 6.3±1.1 to 2.3±1.6 and from 6.1±1 to 2.2±2.2 (p<0.05). However, no significant differences in the HHS, VAS score, and hip FJS at the last follow-up (p>0.05) and 15-year survival rate (84.1% and 86%, respectively, p>0.05) were found between group A and B.Conclusions Autologous and allogeneic fibular grafts can attain equally good clinical outcomes and high survival rates in long-term follow-up, and thus can greatly delay THA owing to good bone osseointegration and sufficient mechanical support. Notably, the ratio of failure will increase when patients were more than 37 years old.Level of Evidence Level III, therapeutic study.

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