Min Byung-Woo, Song Kwang-Soon, Cho Chul-Hyun, Lee Sung-Moon, Lee Kyung-Jae
Department of Orthopaedic Surgery, Keimyung University, School of Medicine, Dongsan Medical Center, 194 Dongsan-dong, Joong-gu, Daegu 700-712, Korea.
Clin Orthop Relat Res. 2008 May;466(5):1087-92. doi: 10.1007/s11999-008-0191-x. Epub 2008 Mar 8.
Because there is no consensus regarding the factors predicting femoral head collapse in asymptomatic osteonecrosis of the hip, we studied the risk factors for collapse. Between 1990 and 2000, we used MRI to confirm asymptomatic osteonecrosis of the femoral head in 81 patients (81 hips) whose other hip had nontraumatic symptomatic osteonecrosis and we monitored them prospectively. The minimum followup was 5 years (mean, 8.3 years; range, 5-16 years). At the latest followup, 31 hips (38%) were symptomatic and 26 hips (32%) had collapsed. The mean interval between diagnosis and collapse was 4.1 years. We observed no correlation between femoral head collapse and patients' age, gender, weight, presumed cause of osteonecrosis, or length of followup. With combined factors, only extent of large necrotic lesion (hazard ratio, 4.06; 95% confidence interval, 1.29-12.77) and location of Type C2 necrotic lesion (hazard ratio, 6.35; 95% confidence interval, 1.18-34.11) predicted collapse.
由于对于无症状性股骨头坏死中预测股骨头塌陷的因素尚无共识，我们对塌陷的危险因素进行了研究。1990年至2000年间，我们使用磁共振成像（MRI）确诊了81例（81髋）股骨头无症状性坏死患者，这些患者的对侧髋关节患有非创伤性有症状性坏死，我们对他们进行了前瞻性监测。最短随访时间为5年（平均8.3年；范围5 - 16年）。在最近一次随访时，31髋（38%）出现症状，26髋（32%）发生塌陷。诊断至塌陷的平均间隔时间为4.1年。我们观察到股骨头塌陷与患者年龄、性别、体重、推测的骨坏死病因或随访时间之间无相关性。综合各因素来看，仅大面积坏死灶范围（风险比，4.06；95%置信区间，1.29 - 12.77）和C2型坏死灶位置（风险比，6.35；95%置信区间，1.18 - 34.11）可预测塌陷。
