Role of MRI in Evaluation of Avascular Necrosis of Femoral Head: A Prospective Study

Objectives. To study the correlation between avascular necrosis and the demographics, time elapsed from fracture to surgery, quality of reduction, Garden classification, and the position of the screw following use of the dynamic hip screw (DHS) in the treatment of subcapital neck fractures. Methods. A prospective study of 96 patients with subcapital neck fractures was carried out in a faculty hospital. Patients underwent surgery with closed reduction and internal fixation with DHS. Results. There were 58% male and 42% female patients, with a mean age of 53 years (+/−14). In terms of Garden classification, 60% were Garden IV, 26% were Garden III, and 14% were Garden II. Nonunion was observed in three cases (3%) and was treated with valgus intertrochanteric osteotomy, in all cases leading to successful healing. Avascular necrosis was observed in 16% of patients. The positioning of the screw into the femoral head showed a significant correlation with necrosis. Conclusions. The incidence of necrosis in patients under the age of 50 years is twice as high as that in older patients. Displacement is a predictive factor regarding osteonecrosis and is associated with a high and anterior position of the screw in the femoral head. Level II of evidence. Study Type: therapeutic study.

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A Prospective Study on Role of Cemented Total Hip Arthroplasty in Osteonecrosis of Hip Joint with Femoral Head Collapse in Elderly: A Study of 100 Cases

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-0655760 ◽

2013 ◽

Vol 6 (5) ◽

pp. 57-60

Author(s):

Dr. Anshul Dahuja Dr. Anshul Dahuja

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Prospective Study ◽

Hip Joint ◽

Hip Arthroplasty ◽

Total Hip ◽

Femoral Head Collapse ◽

A Prospective Study ◽

Cemented Total Hip Arthroplasty

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Role of plain radiograph versus MRI in avascular necrosis of femoral head

MedPulse International Journal of Radiology ◽

10.26611/10131224 ◽

2021 ◽

Vol 12 (2) ◽

pp. 69-71

Author(s):

Amit H Deshmukh ◽

Keyword(s):

Femoral Head ◽

Avascular Necrosis ◽

Joint Destruction ◽

Plain Radiograph ◽

Health Care Centre ◽

X Ray ◽

One Year ◽

The One ◽

Necrosis Of Femoral Head

Background: Avascular necrosis of the femoral head (AVN) is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Although patients are initially asymptomatic, AVN usually progresses to joint destruction, usually before the fifth decade. Aims and Objectives: To study role of plain radiograph versus MRI in Avascular Necrosis of Femoral head. Methodology: This was a cross-sectional study carried out in the patients clinically suspected of avascular necrosis of femur at tertiary health care centre during the one year period i.e. January 2018 to January 2019 during the one year period there were 37 patients suspected of avascular necrosis of Femur The sensitivity and specificity was calculated by ROC curves from the medcal software.Result: In our study we have seen that the sensitivity (Sn)and Specificity (Sp) for X-ray and MRI respectively for various stages was For STAGE Iwas34.29, 29.12and98.45,95.12 ;forSTAGE IIwas 75.12,68.23 and 99.17,98.27;forSTAGE III98.56,93.12and99.69,98.36;forSTAGE IV99.34,92.19and100,99.19 . Conclusion: It can be concluded from our study that in the early stages of disease MRI was highly sensitive and specific as compared to plain X-ray hence MRI should be preferred over the plain X-ray in the confirmation and early surgical intervention if any.

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Role of core decompression and bone marrow grafting in treatment of early avascular necrosis of femoral head

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2020.v6.i3g.2237 ◽

2020 ◽

Vol 6 (3) ◽

pp. 443-448

Author(s):

Dr. Sanjiv Gaur ◽

Dr. Anil Chouksey ◽

Dr. Harendra Singh ◽

Dr. Vipin Singh ◽

Dr. Tapan Jain

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Avascular Necrosis ◽

Core Decompression ◽

Necrosis Of Femoral Head ◽

Bone Marrow Grafting

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A Prospective Study of Management of Fracture Dislocation of Hip (PIPKIN) by Safe Surgical Dislocation (2 Years 6 Months Follow-Up in a Tertiary Hospital at Visakhapatnam)

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/420 ◽

2021 ◽

Vol 8 (26) ◽

pp. 2248-2252

Author(s):

Appala Raju Sanaboyina ◽

Saraswathi Venkata Avula

Keyword(s):

Femoral Head ◽

Prospective Study ◽

Functional Outcome ◽

Avascular Necrosis ◽

Motor Vehicle ◽

Early Arthritis ◽

Tube Placement ◽

Fracture Dislocation ◽

Surgical Dislocation ◽

A Prospective Study

BACKGROUND High velocity motor vehicle injuries are associated with hip fracture dislocations especially dash board injuries. Most commonly posterior hip dislocations are associated with occasional femoral head fractures. Computerized tomographic imaging is done to look at the congruency of the hip joint. Safe surgical dislocation or Ganz approach was described in 2001 for exposing the hip in a 360-degree view without damaging the vascularity of the femoral head. In this study, we wanted to evaluate the radiological and functional outcome using modified Merle d' Aubigne-Postel and Harris hip scoring. METHODS The current study is a prospective study in a tertiary referral centre where 8 young adult males were followed up for a period of 2 years 6 months from August 2018 to February 2021 after safe surgical dislocation and reduction with headless Herbert screws to maintain congruent hip surface. RESULTS We had 1 patient with associated chest injury requiring intercostal tube placement, while none of them had developed avascular necrosis or early arthritis. We had used modified Merle d'Aubigne-Postel and Harris hip scoring to assess the functional outcome. We had six patients with excellent results and two patients with good outcome due to occasional pain. We followed all the patients for more than 2 years. We evaluated the radiological and functional outcomes. The results are comparable to other researcher’s studies. CONCLUSIONS Safe surgical dislocation is a very good choice for fixation of femoral head fractures where the complications like early arthritis of femoral head and acetabulum are less along with preserving the vascularity of the femoral head and preventing the chances of avascular necrosis of femoral head. It also provides a good intraoperative view for handling the fracture reduction. KEYWORDS Pipkin Fracture, Ganz Approach, Safe Surgical Dislocation Hip, Herbert Screw

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