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Clinical and Radiographic Outcomes in Untreated Symptomatic Osteonecrosis of the Femoral Head

Aaron, Roy K. M.D.; Stulberg, Bernard N. M.D.; Lennox, Dennis W. M.D.

Section Editor(s): Aaron, Roy K. M.D.

Techniques in Orthopaedics: March 2001 - Volume 16 - Issue 1 - p 1-5
Osteonecrosis of the Femoral Head: Articles

This study presents the time course of clinical and radiographic progression of symptomatic osteonecrosis of the femoral head and examines those characteristics which may be associated with more rapid progression. Clinical and radiographic progression occurred regardless of initial Ficat stage with some differences in the time course of progression. Radiographic progression was sensitive, but was less specific in predicting eventual clinical failure. Patients aged over 40 years with Ficat stage III hips progressed faster then did other patients with osteonecrosis. Hips with lesions occupying an area greater than 50% of the femoral head were uniformly associated with clinical failure. Clinical failure also correlated with the extent of collapse in Ficat stage III hips. In general, however, progression occurred relatively uniformly and suggested that symptomatic osteonecrosis of the femoral head is a progressive disease.

From the Department of Orthopaedics (Dr. Aaron), Brown University School of Medicine, Providence, Rhode Island; Cleveland Center for Joint Reconstruction (Dr. Stulberg), Cleveland, Ohio; and the Department of Orthopaedics (Dr. Lennox), Johns Hopkins University School of Medicine, Baltimore, Maryland.

Address correspondence and reprint requests to Roy K. Aaron, MD, University Orthopaedics, 100 Butler Drive, Providence, RI 02906.

© 2001 Lippincott Williams & Wilkins, Inc.