조기대퇴골두무혈성괴사에서 괴사범위와 대퇴골두함몰과의 관계 = The Extent of Necrosis Predicts the Fate of Osteonecrosis of the Femoral head

다국어 초록 (Multilingual Abstract)

In a randomized trial conducted to compare the core decompression to the conservative treatment, we tested the hypothesis that the extent of necrosis at the intial magnetic resonance(MR) study predicts the subsequent risk of collapse of the femoral head. After the initial clinical evaluation incluing plain roentgenography and MR imaging, thirty-seven hips of early-stage osteonecrosis(ON) in thirtythree patients were randomly assigned to core decompression group or conservative treatment group. All the patients were regularly followed by clinical evaluation, plain roentgenography and MR imag- ing at three-month intervals. The extent of ON was estimated on the basis of the percentage of abnormal signal intensity in the weight-bearing portion of the femoral head as determined on a combination in coronal and sagittal MR images. The angle of necrotic portion in mid-coronal image(A) and that in mid-sagittal image(B) were used to quantify the extent of necrotic portion by the formular;(A/180)x(B/180)x100%. A strong correlation was observed between the percentage of necrotic portion and the development of collapse. We concluded that the extent of necrotic portion is a major risk factor of the collapse and proposed a systematic method of classifying the percentage of necrotic portion which might be useful as a predictive index for that fate of early-stage ON.