Sakai T, Sugano N, Ohzono K, Matsui M, Hiroshima K, Ochi T
Department of Orthopedic Surgery, Osaka University Medical School, Suita, Japan.
Acta Orthop Scand. 1998 Dec;69(6):598-602. doi: 10.3109/17453679808999263.
We reviewed 30 patients (46 knees) with steroid- or alcohol-related osteonecrosis of the femoral condyle. Their average age was 35 (14-61) years and the mean observation time was 7 (3-16) years. The medio-lateral extent and the anterior-posterior (AP) location of the necrotic lesion were evaluated on T1-weighted MRI and related to the collapse of the condyle. The size of the lesion was classified into three categories on the mid-coronal MRI of the femoral condyle: there were 44 small, 20 medium, and 9 large lesions. The condyle was divided into 3 zones: anterior, middle, and posterior. The location of the lesion was evaluated on the mid-sagittal image. There were 7 anterior, 9 middle, 29 posterior, 14 middle and posterior and, in 14 cases, all 3 zones were involved. 44 small lesions did not collapse, while 6/20 medium lesions and 5/9 large lesions collapsed. No lesion involving only one zone collapsed, while 4/14 lesions involving the middle and posterior zones and 7/14 lesions involving all three zones progressed to collapse. 4/6 condyles with large necrotic lesions involving all three zones collapsed. We conclude that the extent of the necrotic lesion on both the mid-coronal and mid-sagittal planes is of importance for the prognosis of osteonecrosis of the femoral condyle.
我们回顾性分析了30例（46个膝关节）与类固醇或酒精相关的股骨髁骨坏死患者。他们的平均年龄为35岁（14 - 61岁），平均观察时间为7年（3 - 16年）。在T1加权磁共振成像（MRI）上评估坏死灶的内外侧范围和前后（AP）位置，并与髁的塌陷情况相关联。在股骨髁的中冠状面MRI上，将病灶大小分为三类：有44个小病灶、20个中等病灶和9个大病灶。将髁分为三个区域：前部、中部和后部。在矢状面图像上评估病灶的位置。有7个病灶位于前部，9个位于中部，29个位于后部，14个位于中部和后部，14例中所有三个区域均受累。44个小病灶未发生塌陷，而20个中等病灶中有6个、9个大病灶中有5个发生了塌陷。仅累及一个区域的病灶均未发生塌陷，而累及中部和后部区域的14个病灶中有4个、累及所有三个区域的14个病灶中有7个进展为塌陷。累及所有三个区域的4/6个大坏死灶的髁发生了塌陷。我们得出结论，股骨髁骨坏死的坏死灶在中冠状面和矢状面上的范围对其预后具有重要意义。
