Radiologic measurements associated with the prognosis and need for surgery in patients with subchondral insufficiency fractures of the femoral head

Kenyu Iwasaki, Takuaki Yamamoto, goro motomura, Satoshi Ikemura, Ryosuke Yamaguchi, Yukihide Iwamoto

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Abstract

OBJECTIVE. The objective of this study was to identify the risk factors associated with the prognosis and need for surgery of patients with subchondral insufficiency fractures of the femoral head. MATERIALS AND METHODS. Twenty-nine consecutively registered patients with subchondral insufficiency fractures of the femoral head were divided into the two groups: a nonprogression of collapse group, which included patients who had no collapse or 2 mm or less of collapse of the femoral head and whose symptoms resolved (14 patients), and a progression of collapse group, which included patients who had more than 2 mm of collapse, for which surgery was indicated (15 patients). Both groups received the same conservative therapy. The following radiographic measurements were obtained: Sharp angle, center edge angle, acetabular roof angle, and acetabular head index. On MR images, band length, defined as the length of a lowsignal-intensity band in the coronal plane, and band length ratio, defined as the proportion of the band length relative to the weight bearing portion, were assessed for each patient. Bone mineral density measurements (T score) were available for 17 patients. RESULTS. In the univariate analyses, T score, Sharp angle, center edge angle, acetabular roof angle, acetabular head index, band length, and band length ratio were found to be significant prognostic factors. Multivariate analyses of T score, acetabular head index, and band length ratio showed that both acetabular head index and band length ratio were significant predictors. CONCLUSION. Both acetabular head index and band length ratio are important prognostic factors in the care of patients with subchondral insufficiency fractures of the femoral head.

Original languageEnglish
JournalAmerican Journal of Roentgenology
Volume201
Issue number1
DOIs
Publication statusPublished - Jul 1 2013

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Stress Fractures
Thigh
Head
Weight-Bearing
Bone Density
Patient Care
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Radiologic measurements associated with the prognosis and need for surgery in patients with subchondral insufficiency fractures of the femoral head",
abstract = "OBJECTIVE. The objective of this study was to identify the risk factors associated with the prognosis and need for surgery of patients with subchondral insufficiency fractures of the femoral head. MATERIALS AND METHODS. Twenty-nine consecutively registered patients with subchondral insufficiency fractures of the femoral head were divided into the two groups: a nonprogression of collapse group, which included patients who had no collapse or 2 mm or less of collapse of the femoral head and whose symptoms resolved (14 patients), and a progression of collapse group, which included patients who had more than 2 mm of collapse, for which surgery was indicated (15 patients). Both groups received the same conservative therapy. The following radiographic measurements were obtained: Sharp angle, center edge angle, acetabular roof angle, and acetabular head index. On MR images, band length, defined as the length of a lowsignal-intensity band in the coronal plane, and band length ratio, defined as the proportion of the band length relative to the weight bearing portion, were assessed for each patient. Bone mineral density measurements (T score) were available for 17 patients. RESULTS. In the univariate analyses, T score, Sharp angle, center edge angle, acetabular roof angle, acetabular head index, band length, and band length ratio were found to be significant prognostic factors. Multivariate analyses of T score, acetabular head index, and band length ratio showed that both acetabular head index and band length ratio were significant predictors. CONCLUSION. Both acetabular head index and band length ratio are important prognostic factors in the care of patients with subchondral insufficiency fractures of the femoral head.",
author = "Kenyu Iwasaki and Takuaki Yamamoto and goro motomura and Satoshi Ikemura and Ryosuke Yamaguchi and Yukihide Iwamoto",
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T1 - Radiologic measurements associated with the prognosis and need for surgery in patients with subchondral insufficiency fractures of the femoral head

AU - Iwasaki, Kenyu

AU - Yamamoto, Takuaki

AU - motomura, goro

AU - Ikemura, Satoshi

AU - Yamaguchi, Ryosuke

AU - Iwamoto, Yukihide

PY - 2013/7/1

Y1 - 2013/7/1

N2 - OBJECTIVE. The objective of this study was to identify the risk factors associated with the prognosis and need for surgery of patients with subchondral insufficiency fractures of the femoral head. MATERIALS AND METHODS. Twenty-nine consecutively registered patients with subchondral insufficiency fractures of the femoral head were divided into the two groups: a nonprogression of collapse group, which included patients who had no collapse or 2 mm or less of collapse of the femoral head and whose symptoms resolved (14 patients), and a progression of collapse group, which included patients who had more than 2 mm of collapse, for which surgery was indicated (15 patients). Both groups received the same conservative therapy. The following radiographic measurements were obtained: Sharp angle, center edge angle, acetabular roof angle, and acetabular head index. On MR images, band length, defined as the length of a lowsignal-intensity band in the coronal plane, and band length ratio, defined as the proportion of the band length relative to the weight bearing portion, were assessed for each patient. Bone mineral density measurements (T score) were available for 17 patients. RESULTS. In the univariate analyses, T score, Sharp angle, center edge angle, acetabular roof angle, acetabular head index, band length, and band length ratio were found to be significant prognostic factors. Multivariate analyses of T score, acetabular head index, and band length ratio showed that both acetabular head index and band length ratio were significant predictors. CONCLUSION. Both acetabular head index and band length ratio are important prognostic factors in the care of patients with subchondral insufficiency fractures of the femoral head.

AB - OBJECTIVE. The objective of this study was to identify the risk factors associated with the prognosis and need for surgery of patients with subchondral insufficiency fractures of the femoral head. MATERIALS AND METHODS. Twenty-nine consecutively registered patients with subchondral insufficiency fractures of the femoral head were divided into the two groups: a nonprogression of collapse group, which included patients who had no collapse or 2 mm or less of collapse of the femoral head and whose symptoms resolved (14 patients), and a progression of collapse group, which included patients who had more than 2 mm of collapse, for which surgery was indicated (15 patients). Both groups received the same conservative therapy. The following radiographic measurements were obtained: Sharp angle, center edge angle, acetabular roof angle, and acetabular head index. On MR images, band length, defined as the length of a lowsignal-intensity band in the coronal plane, and band length ratio, defined as the proportion of the band length relative to the weight bearing portion, were assessed for each patient. Bone mineral density measurements (T score) were available for 17 patients. RESULTS. In the univariate analyses, T score, Sharp angle, center edge angle, acetabular roof angle, acetabular head index, band length, and band length ratio were found to be significant prognostic factors. Multivariate analyses of T score, acetabular head index, and band length ratio showed that both acetabular head index and band length ratio were significant predictors. CONCLUSION. Both acetabular head index and band length ratio are important prognostic factors in the care of patients with subchondral insufficiency fractures of the femoral head.

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