Computed tomography with multiplanar reformation and 3-dimensional image analysis in the preoperative evaluation of ischemic necrosis of the femoral head.

Computed tomography (CT) with multiplanar reformation and 3-dimensional image reconstruction were utilized preoperatively to assess the extent of infarction and collapse of the femoral head in 15 patients with ischemic necrosis. Polyethylene models of the diseased femoral heads were constructed from 3-dimensional contouring of CT data, and compared with resected specimens in patients who underwent subsequent total hip arthroplasty. Information provided by this imaging strategy was valuable in both the selection and the planning of the most appropriate surgical procedure, and models were found to represent resected head configurations with reasonable accuracy. CT combined with multiplanar reformation and 3-dimensional analysis may be the optimal preoperative means for evaluating advanced ischemic necrosis involving the femoral head.