Spontaneous resolution of osteonecrosis of the femoral head
Spontaneous resolution of osteonecrosis of the femoral head
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DOI：
10.2106/00004623-200412000-00002
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发表时间：
2004-12-01
影响因子：
5.3
通讯作者：
Saleh, KJ
中科院分区：
文献类型：
--
作者：
Cheng, EY;Thongtrangan, I;Saleh, KJ
背景：对无症状股骨头坏死进行手术治疗的决定是有争议的。本研究的目的是确定（1）股骨头坏死是否会自发消退，（2）消退需要多长时间，（3）是否有自发消退的预测因子。方法：无症状股骨头坏死患者从两项国立卫生研究院资助的筛选研究中确定：一项针对器官移植后股骨头骨坏死的前瞻性筛查研究，以及一项对接受过症状性股骨头骨坏死手术治疗的患者进行对侧无症状髋关节骨坏死筛查的研究。队列的无症状股骨头坏死的患者进行了analysed.Results：13例无症状髋关节在器官移植后骨坏死的前瞻性筛选研究中被确定，17例髋关节在对侧hipscreening研究中被确定。三个髋关节，都来自于接受器官移植的患者组，具有协会研究循环骨分期疾病，随后通过系列磁共振成像扫描证明自发消退。在这三个髋关节中，改良的坏死程度指数分别为11.10、12.72和20.83，其中两个髋关节股骨头受累的估计百分比为15%至30%，
Background: The decision to proceed with surgical treatment of asymptomatic osteonecrosis of the femoral head is controversial. The purpose of the present study was to determine (1) if spontaneous resolution of osteonecrosis of the femoral head occurs, (2) how long it takes for resolution to occur, and (3) if there are predictors of spontaneous resolution.Methods: Patients with asymptomatic osteonecrosis of the femoral head were identified from two National Institutes of Health-funded screening studies: a prospective screening study for osteonecrosis of the femoral head after organ transplantation and a study in which patients who had had surgical treatment of symptomatic osteonecrosis of the femoral head were screened for osteonecrosis of the contralateral, asymptomatic hip. The cohort of patients with asymptomatic osteonecrosis of the femoral head was then analyzed.Results: Thirteen asymptomatic hips in ten patients were identified in the prospective screening study for osteonecrosis after organ transplantation, and seventeen hips in seventeen patients were identified in the contralateral hipscreening study. Three hips, all from the group of patients who had had organ transplantation, had Association Research Circulation Osseous staged disease with spontaneous resolution occurring later as evidenced by serial magnetic resonance imaging scans. In these three hips, the modified index of necrotic extent measured 11.10, 12.72, and 20.83, with the estimated percentage of femoral head involvement being 15% to 30% in two of the hips and