The role of hip arthroscopy in the evaluation of avascular necrosis.

Journal Article (Journal Article)

This prospective study evaluated the correlation between plain radiographs, magnetic resonance imaging (MRI), and diagnostic arthroscopy in the staging of avascular necrosis of the femoral head. Fifty-two hips in 46 patients were prospectively staged using radiographic and MRI staging systems. Patients subsequently underwent hip arthroscopy to visualize the articular surface prior to considering salvage of the femoral head and debride delaminated osteochondral fragments. Weighted Kappa analysis revealed only moderate correlation between MRI and plain radiographs (K=.11), MRI and arthroscopy (K=.21), and plain radiographs and arthroscopy (K=.19). Six (46%) of 13 patients with a radiographically apparent subchondral fracture demonstrated collapse of the articular surface at arthroscopy. Four (24%) of 17 hips with >2 mm of collapse of the femoral head on plain radiographs demonstrated fragmentation of the osteochondral surface of the femoral head at arthroscopy. In 5 patients with flattening of the femoral head, 3 patients had delamination of both the femoral and acetabular surfaces. In regard to labral pathology, 5 of 22 post-collapse hips also had large bucket handle tears of the labrum. Arthroscopy of the hip revealed osteochondral degeneration that was not detected by plain radiographs or MRI in 36% of post-collapse femoral heads.

Full Text

Duke Authors

Cited Authors

  • Ruch, DS; Sekiya, J; Dickson Schaefer, W; Koman, LA; Pope, TL; Poehling, GG

Published Date

  • April 2001

Published In

Volume / Issue

  • 24 / 4

Start / End Page

  • 339 - 343

PubMed ID

  • 11332961

International Standard Serial Number (ISSN)

  • 0147-7447

Digital Object Identifier (DOI)

  • 10.3928/0147-7447-20010401-15


  • eng

Conference Location

  • United States