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

Publication ,  Journal Article
Ruch, DS; Sekiya, J; Dickson Schaefer, W; Koman, LA; Pope, TL; Poehling, GG
Published in: Orthopedics
April 2001

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.

Duke Scholars

Published In

Orthopedics

DOI

ISSN

0147-7447

Publication Date

April 2001

Volume

24

Issue

4

Start / End Page

339 / 343

Location

United States

Related Subject Headings

  • Radiography
  • Prospective Studies
  • Orthopedics
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Femur Head Necrosis
  • Female
  • Arthroscopy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ruch, D. S., Sekiya, J., Dickson Schaefer, W., Koman, L. A., Pope, T. L., & Poehling, G. G. (2001). The role of hip arthroscopy in the evaluation of avascular necrosis. Orthopedics, 24(4), 339–343. https://doi.org/10.3928/0147-7447-20010401-15
Ruch, D. S., J. Sekiya, W. Dickson Schaefer, L. A. Koman, T. L. Pope, and G. G. Poehling. “The role of hip arthroscopy in the evaluation of avascular necrosis.Orthopedics 24, no. 4 (April 2001): 339–43. https://doi.org/10.3928/0147-7447-20010401-15.
Ruch DS, Sekiya J, Dickson Schaefer W, Koman LA, Pope TL, Poehling GG. The role of hip arthroscopy in the evaluation of avascular necrosis. Orthopedics. 2001 Apr;24(4):339–43.
Ruch, D. S., et al. “The role of hip arthroscopy in the evaluation of avascular necrosis.Orthopedics, vol. 24, no. 4, Apr. 2001, pp. 339–43. Pubmed, doi:10.3928/0147-7447-20010401-15.
Ruch DS, Sekiya J, Dickson Schaefer W, Koman LA, Pope TL, Poehling GG. The role of hip arthroscopy in the evaluation of avascular necrosis. Orthopedics. 2001 Apr;24(4):339–343.

Published In

Orthopedics

DOI

ISSN

0147-7447

Publication Date

April 2001

Volume

24

Issue

4

Start / End Page

339 / 343

Location

United States

Related Subject Headings

  • Radiography
  • Prospective Studies
  • Orthopedics
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Femur Head Necrosis
  • Female
  • Arthroscopy