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KMID : 0386720010130010051
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Journal of the Korean Hip Society
2001 Volume.13 No. 1 p.51 ~ p.57
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Appearance of Symptom in Asymptomatic Osteonecrosis of Femoral Head
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Won Choong-Hee
Kim Yong-Min
Choi Eui-Sung
Lee Ho-Seung
Seo Joong-Bae
Bae Byoung-Gwon
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Abstract
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Purpose: To validate the possibility of a later appearance of symptom and progression of disease in asymptomatic osteonecrosis of the femoral head.
Materials & Methods: We reviewed 39 asymptomatic hips where the contralateral hip had been operated with THR due to avascular necrosis of the femoral head. Preoperative MRI was completed in all cases and the untreated hips were classified into the ARCO stage. After over 2 years of follow up, the patients were evaluated by questionnaire for the appearance of symptoms.
Results: Among the 39 cases, necrotic findings of the femoral head were observed in 21 cases and no abnormal findings were observed in 18 cases. Among the 21 cases with initial necrosis, symptoms appeared in 8 cases (38.1%) after follow up. One case was ARCO Stage 1, and the remaining seven cases were ARCO Stage 2. According to size, one case was A, 3 cases were B, and 4 cases were C. According to location, 4 cases were Ohzono type 1-B and 4 cases were Ohzono type 1-C. The asymptomatic period ranged from 6 months to 36 months (mean; 17 months). The 18 cases that had no lesion on initial MRI were completely asymptomatic.
Conclusion: In the case of ARCO stage 1 or 2, none of the necrotic femoral heads progressed. Except for the case of lesion size C with Ohzono type 1-C, the cases with symptom appearance were relatively lower. Therefore, early operative treatment is not recommended in the early avascular necrosis of the femoral head of ARCO classification A or B based on size and anatomic location.
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KEYWORD
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Femoral head, Avascular necrosis, Asymptomatic hip, Symptom appearance 57
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