Ito H, Matsuno T, Kaneda K
Department of Orthopaedic Surgery, Hokkaido University, School of Medicine, Sapporo, Japan.
Clin Orthop Relat Res. 1999 Jan(358):149-57.
Seventy-two femoral heads in 63 patients in whom avascular necrosis of the femoral head was in the early stage were followed up prospectively for a mean period of 6 years 1 month. All of the necrotic lesions were confirmed by magnetic resonance imaging. At the time of final outcome, 46 (64%) of the 72 hips were symptomatic. Necrotic lesions greater than 2/3 of the weightbearing portion on T1 weighted central coronal images indicated a high risk of clinical deterioration. Fifty-nine of the 72 hips initially had necrotic lesions greater than 2/3 of the weightbearing portion, and 44 (75%) of these 59 hips were symptomatic at the final outcome. However, in the radiographic assessment of 15 (25%) asymptomatic hips, even when the necrotic lesions were greater than 2/3 of the weightbearing portion as shown by magnetic resonance imaging, the continuous absence of any radiographic abnormality indicated the possibility of a continuous asymptomatic stage for at least several years.
对63例股骨头缺血性坏死早期患者的72个股骨头进行了平均6年1个月的前瞻性随访。所有坏死病变均经磁共振成像证实。在最终随访时，72个髋关节中有46个（64%）出现症状。T1加权中央冠状位图像上坏死病变大于负重部分的2/3提示临床恶化风险高。72个髋关节中有59个最初坏死病变大于负重部分的2/3，这59个髋关节中有44个（75%）在最终随访时出现症状。然而，在对15个（25%）无症状髋关节的X线评估中，即使磁共振成像显示坏死病变大于负重部分的2/3，但持续未出现任何X线异常表明至少在几年内可能处于持续无症状阶段。
