Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 3/2015

01-09-2015 | Modern Surgical Treatment of Hip Avascular Necrosis (MA Mont, Section Editor)

Osteonecrosis of the femoral head: diagnosis and classification systems

Authors: Ho-Rim Choi, Marvin E. Steinberg, Edward Y. Cheng

Published in: Current Reviews in Musculoskeletal Medicine | Issue 3/2015

Login to get access

Abstract

Osteonecrosis of femoral head is a rare but disabling condition that usually results in progressive femoral head collapse and secondary arthritis necessitating total hip arthroplasty if not treated appropriately in early stages. However, early diagnosis is challenging as the onset of disease is insidious and the symptoms and signs are usually minimal and nonspecific until it becomes advanced. Of several diagnostic modalities, magnetic resonance imaging (MRI) is considered the imaging method of choice with the highest sensitivity and specificity, while detection of potential risk factors is very important as well. Many investigators have developed several different classification systems; however, there still is controversy regarding the optimal classification system. Diagnostic methods and the evolution of different classification systems will be reviewed in this paper.
Literature
1.
go back to reference Lieberman JR, Berry DJ, Mont MA, Aaron RK, Callaghan JJ, Rajadhyaksha AD, et al. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect. 2003;52:337–55.PubMed Lieberman JR, Berry DJ, Mont MA, Aaron RK, Callaghan JJ, Rajadhyaksha AD, et al. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect. 2003;52:337–55.PubMed
2.•
go back to reference Steinberg ME, Steinberg DR. Osteonecrosis: Historical perspective. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 3–15. The study describes historical perspective of diagnosis, classification, and treatment of osteonecrosis . Steinberg ME, Steinberg DR. Osteonecrosis: Historical perspective. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 3–15. The study describes historical perspective of diagnosis, classification, and treatment of osteonecrosis .
3.
go back to reference Zalavras CG, Lieberman JR. Osteonecrosis of the femoral head: evaluation and treatment. J Am Acad Orthop Surg. 2014;22(7):455–64.PubMedCrossRef Zalavras CG, Lieberman JR. Osteonecrosis of the femoral head: evaluation and treatment. J Am Acad Orthop Surg. 2014;22(7):455–64.PubMedCrossRef
4.
go back to reference Lu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am. 1994;76(1):15–25.PubMed Lu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am. 1994;76(1):15–25.PubMed
5.
go back to reference Min BW, Kim SJ. Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture. Orthopedics. 2011;34(5):349.PubMed Min BW, Kim SJ. Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture. Orthopedics. 2011;34(5):349.PubMed
6.
go back to reference Naranje SM, Cheng EY. Epidemiology of osteonecrosis in the USA. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 39–45. Naranje SM, Cheng EY. Epidemiology of osteonecrosis in the USA. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 39–45.
7.
go back to reference Protzman RR, Burkhalter WE. Femoral-neck fractures in young adults. J Bone Joint Surg Am. 1976;58(5):689–95.PubMed Protzman RR, Burkhalter WE. Femoral-neck fractures in young adults. J Bone Joint Surg Am. 1976;58(5):689–95.PubMed
8.
go back to reference Tooke SM, Favero KJ. Femoral neck fractures in skeletally mature patients, fifty years old or less. J Bone Joint Surg Am. 1985;67(8):1255–60.PubMed Tooke SM, Favero KJ. Femoral neck fractures in skeletally mature patients, fifty years old or less. J Bone Joint Surg Am. 1985;67(8):1255–60.PubMed
9.
go back to reference Dora C, Leunig M, Beck M, Rothenfluh D, Ganz R. Entry point soft tissue damage in antegrade femoral nailing: a cadaver study. J Orthop Trauma. 2001;15(7):488–93.PubMedCrossRef Dora C, Leunig M, Beck M, Rothenfluh D, Ganz R. Entry point soft tissue damage in antegrade femoral nailing: a cadaver study. J Orthop Trauma. 2001;15(7):488–93.PubMedCrossRef
10.
go back to reference Orler R, Hersche O, Helfet DL, Mayo KA, Ward T, Ganz R. Avascular femur head necrosis as severe complication after femoral intramedullary nailing in children and adolescents. Unfallchirurg. 1998;101(6):495–9.PubMedCrossRef Orler R, Hersche O, Helfet DL, Mayo KA, Ward T, Ganz R. Avascular femur head necrosis as severe complication after femoral intramedullary nailing in children and adolescents. Unfallchirurg. 1998;101(6):495–9.PubMedCrossRef
11.
go back to reference Cui Q, Wang Y, Saleh KJ, Wang GJ, Balian G. Alcohol-induced adipogenesis in a cloned bone-marrow stem cell. J Bone Joint Surg Am. 2006;88 Suppl 3:148–54.PubMedCrossRef Cui Q, Wang Y, Saleh KJ, Wang GJ, Balian G. Alcohol-induced adipogenesis in a cloned bone-marrow stem cell. J Bone Joint Surg Am. 2006;88 Suppl 3:148–54.PubMedCrossRef
12.
go back to reference Wang Y, Li Y, Mao K, Li J, Cui Q, Wang GJ. Alcohol-induced adipogenesis in bone and marrow: a possible mechanism for osteonecrosis. Clin Orthop Relat Res. 2003;410:213–24.PubMedCrossRef Wang Y, Li Y, Mao K, Li J, Cui Q, Wang GJ. Alcohol-induced adipogenesis in bone and marrow: a possible mechanism for osteonecrosis. Clin Orthop Relat Res. 2003;410:213–24.PubMedCrossRef
13.
go back to reference Orlic D, Jovanovic S, Anticevic D, Zecevic J. Frequency of idiopathic aseptic necrosis in medically treated alcoholics. Int Orthop. 1990;14(4):383–6.PubMedCrossRef Orlic D, Jovanovic S, Anticevic D, Zecevic J. Frequency of idiopathic aseptic necrosis in medically treated alcoholics. Int Orthop. 1990;14(4):383–6.PubMedCrossRef
14.
go back to reference Jacobs B. Alcoholism-induced bone necrosis. N Y State J Med. 1992;92(8):334–8.PubMed Jacobs B. Alcoholism-induced bone necrosis. N Y State J Med. 1992;92(8):334–8.PubMed
15.
go back to reference Nakamura J, Saisu T, Yamashita K, Suzuki C, Kamegaya M, Takahashi K. Age at time of corticosteroid administration is a risk factor for osteonecrosis in pediatric patients with systemic lupus erythematosus: a prospective magnetic resonance imaging study. Arthritis Rheum. 2010;62(2):609–15.PubMed Nakamura J, Saisu T, Yamashita K, Suzuki C, Kamegaya M, Takahashi K. Age at time of corticosteroid administration is a risk factor for osteonecrosis in pediatric patients with systemic lupus erythematosus: a prospective magnetic resonance imaging study. Arthritis Rheum. 2010;62(2):609–15.PubMed
16.
go back to reference Saisu T, Sakamoto K, Yamada K, Kashiwabara H, Yokoyama T, Iida S, et al. High incidence of osteonecrosis of femoral head in patients receiving more than 2 g of intravenous methylprednisolone after renal transplantation. Transplant Proc. 1996;28(3):1559–60.PubMed Saisu T, Sakamoto K, Yamada K, Kashiwabara H, Yokoyama T, Iida S, et al. High incidence of osteonecrosis of femoral head in patients receiving more than 2 g of intravenous methylprednisolone after renal transplantation. Transplant Proc. 1996;28(3):1559–60.PubMed
18.
go back to reference Li H, Zhang J, He JW, Wang K, Wang GS, Jiang N, et al. Symptomatic osteonecrosis of the femoral head after adult orthotopic liver transplantation. Chin Med J. 2012;125(14):2422–6.PubMed Li H, Zhang J, He JW, Wang K, Wang GS, Jiang N, et al. Symptomatic osteonecrosis of the femoral head after adult orthotopic liver transplantation. Chin Med J. 2012;125(14):2422–6.PubMed
20.
go back to reference Marston SB, Gillingham K, Bailey RF, Cheng EY. Osteonecrosis of the femoral head after solid organ transplantation: a prospective study. J Bone Joint Surg Am. 2002;84-A(12):2145–51.PubMed Marston SB, Gillingham K, Bailey RF, Cheng EY. Osteonecrosis of the femoral head after solid organ transplantation: a prospective study. J Bone Joint Surg Am. 2002;84-A(12):2145–51.PubMed
21.
go back to reference Mattano Jr LA, Sather HN, Trigg ME, Nachman JB. Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: a report from the Children’s Cancer Group. J Clin Oncol Off J Am Soc Clin Oncol. 2000;18(18):3262–72. Mattano Jr LA, Sather HN, Trigg ME, Nachman JB. Osteonecrosis as a complication of treating acute lymphoblastic leukemia in children: a report from the Children’s Cancer Group. J Clin Oncol Off J Am Soc Clin Oncol. 2000;18(18):3262–72.
22.
go back to reference Sharma S, Leung WH, Deqing P, Yang J, Rochester R, Britton L, et al. Osteonecrosis in children after allogeneic hematopoietic cell transplantation: study of prevalence, risk factors and longitudinal changes using MR imaging. Bone Marrow Transplant. 2012;47(8):1067–74.PubMedCentralPubMedCrossRef Sharma S, Leung WH, Deqing P, Yang J, Rochester R, Britton L, et al. Osteonecrosis in children after allogeneic hematopoietic cell transplantation: study of prevalence, risk factors and longitudinal changes using MR imaging. Bone Marrow Transplant. 2012;47(8):1067–74.PubMedCentralPubMedCrossRef
23.
go back to reference Tauchmanova L, De Rosa G, Serio B, Fazioli F, Mainolfi C, Lombardi G, et al. Avascular necrosis in long-term survivors after allogeneic or autologous stem cell transplantation: a single center experience and a review. Cancer. 2003;97(10):2453–61. doi:10.1002/cncr.11373.PubMedCrossRef Tauchmanova L, De Rosa G, Serio B, Fazioli F, Mainolfi C, Lombardi G, et al. Avascular necrosis in long-term survivors after allogeneic or autologous stem cell transplantation: a single center experience and a review. Cancer. 2003;97(10):2453–61. doi:10.​1002/​cncr.​11373.PubMedCrossRef
24.
go back to reference Torii Y, Hasegawa Y, Kubo T, Kodera Y, Minami S, Morishita Y, et al. Osteonecrosis of the femoral head after allogeneic bone marrow transplantation. Clin Orthop Relat Res. 2001;382:124–32.PubMedCrossRef Torii Y, Hasegawa Y, Kubo T, Kodera Y, Minami S, Morishita Y, et al. Osteonecrosis of the femoral head after allogeneic bone marrow transplantation. Clin Orthop Relat Res. 2001;382:124–32.PubMedCrossRef
25.•
go back to reference Shigemura T, Nakamura J, Kishida S, Harada Y, Ohtori S, Kamikawa K, et al. Incidence of osteonecrosis associated with corticosteroid therapy among different underlying diseases: prospective MRI study. Rheumatology. 2011;50(11):2023–8. This prospective MRI analysis presents the incidence of osteonecrosis associated with corticosteroid therapy between systemic lupus erythematosus and non-systemic lupus erythematosus. PubMedCrossRef Shigemura T, Nakamura J, Kishida S, Harada Y, Ohtori S, Kamikawa K, et al. Incidence of osteonecrosis associated with corticosteroid therapy among different underlying diseases: prospective MRI study. Rheumatology. 2011;50(11):2023–8. This prospective MRI analysis presents the incidence of osteonecrosis associated with corticosteroid therapy between systemic lupus erythematosus and non-systemic lupus erythematosus. PubMedCrossRef
26.
go back to reference Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br Vol. 1995;77:34–41. Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br Vol. 1995;77:34–41.
27.
go back to reference Rodrigue SW, Rosenthal DI, Barton NW, Zurakowski D, Mankin HJ. Risk factors for osteonecrosis in patients with type 1 Gaucher’s disease. Clin Orthop Relat Res. 1999;362:201–7.PubMed Rodrigue SW, Rosenthal DI, Barton NW, Zurakowski D, Mankin HJ. Risk factors for osteonecrosis in patients with type 1 Gaucher’s disease. Clin Orthop Relat Res. 1999;362:201–7.PubMed
28.
go back to reference Morse CG, Mican JM, Jones EC, Joe GO, Rick ME, Formentini E, et al. The incidence and natural history of osteonecrosis in HIV-infected adults. Clin Infect Dis Off Publ Infect Dis Soc Am. 2007;44(5):739–48.CrossRef Morse CG, Mican JM, Jones EC, Joe GO, Rick ME, Formentini E, et al. The incidence and natural history of osteonecrosis in HIV-infected adults. Clin Infect Dis Off Publ Infect Dis Soc Am. 2007;44(5):739–48.CrossRef
30.
go back to reference Molia AC, Strady C, Rouger C, Beguinot IM, Berger JL, Trenque TC. Osteonecrosis in six HIV-infected patients receiving highly active antiretroviral therapy. Ann Pharmacother. 2004;38(12):2050–4. doi:10.1345/aph.1E154.PubMedCrossRef Molia AC, Strady C, Rouger C, Beguinot IM, Berger JL, Trenque TC. Osteonecrosis in six HIV-infected patients receiving highly active antiretroviral therapy. Ann Pharmacother. 2004;38(12):2050–4. doi:10.​1345/​aph.​1E154.PubMedCrossRef
31.
go back to reference Reddy R, Daftary MN, Delapenha R, Dutta A, Oliver J, Frederick W. Avascular necrosis and protease inhibitors. J Natl Med Assoc. 2005;97(11):1543–6.PubMedCentralPubMed Reddy R, Daftary MN, Delapenha R, Dutta A, Oliver J, Frederick W. Avascular necrosis and protease inhibitors. J Natl Med Assoc. 2005;97(11):1543–6.PubMedCentralPubMed
32.
go back to reference Keruly JC, Chaisson RE, Moore RD. Increasing incidence of avascular necrosis of the hip in HIV-infected patients. J Acquir Immune Defic Syndr. 2001;28(1):101–2.PubMedCrossRef Keruly JC, Chaisson RE, Moore RD. Increasing incidence of avascular necrosis of the hip in HIV-infected patients. J Acquir Immune Defic Syndr. 2001;28(1):101–2.PubMedCrossRef
33.
go back to reference Matos MA, Alencar RW, Matos SS. Avascular necrosis of the femoral head in HIV infected patients. Braz J Infect Dis Off Publ Braz Soc Infect Dis. 2007;11(1):31–4. Matos MA, Alencar RW, Matos SS. Avascular necrosis of the femoral head in HIV infected patients. Braz J Infect Dis Off Publ Braz Soc Infect Dis. 2007;11(1):31–4.
34.
go back to reference Mazzotta E, Agostinone A, Rosso R, Di Biagio A, De Socio GV, Cappelletti A, et al. Osteonecrosis in human immunodeficiency virus (HIV)-infected patients: a multicentric case-control study. J Bone Miner Metab. 2011;29(3):383–8.PubMedCrossRef Mazzotta E, Agostinone A, Rosso R, Di Biagio A, De Socio GV, Cappelletti A, et al. Osteonecrosis in human immunodeficiency virus (HIV)-infected patients: a multicentric case-control study. J Bone Miner Metab. 2011;29(3):383–8.PubMedCrossRef
35.
go back to reference Whitlock GG, Herbert S, Copas A, Gilson R, Ainsworth JG. Avascular necrosis in HIV patients: a case-control study. Int J STD AIDS. 2013;24(10):799–803.PubMedCrossRef Whitlock GG, Herbert S, Copas A, Gilson R, Ainsworth JG. Avascular necrosis in HIV patients: a case-control study. Int J STD AIDS. 2013;24(10):799–803.PubMedCrossRef
36.
go back to reference Jones Jr JP. Coagulopathies and osteonecrosis. Acta Orthop Belg. 1999;65 Suppl 1:5–8.PubMed Jones Jr JP. Coagulopathies and osteonecrosis. Acta Orthop Belg. 1999;65 Suppl 1:5–8.PubMed
37.
go back to reference Zalavras C, Dailiana Z, Elisaf M, Bairaktari E, Vlachogiannopoulos P, Katsaraki A, et al. Potential aetiological factors concerning the development of osteonecrosis of the femoral head. Eur J Clin Investig. 2000;30(3):215–21.CrossRef Zalavras C, Dailiana Z, Elisaf M, Bairaktari E, Vlachogiannopoulos P, Katsaraki A, et al. Potential aetiological factors concerning the development of osteonecrosis of the femoral head. Eur J Clin Investig. 2000;30(3):215–21.CrossRef
38.
go back to reference Zalavras CG, Vartholomatos G, Dokou E, Malizos KN. Factor V Leiden and prothrombin gene mutations in femoral head osteonecrosis. Thromb Haemost. 2002;87(6):1079–80.PubMed Zalavras CG, Vartholomatos G, Dokou E, Malizos KN. Factor V Leiden and prothrombin gene mutations in femoral head osteonecrosis. Thromb Haemost. 2002;87(6):1079–80.PubMed
39.
go back to reference Zalavras CG, Vartholomatos G, Dokou E, Malizos KN. Genetic background of osteonecrosis: associated with thrombophilic mutations? Clin Orthop Relat Res. 2004;422:251–5.PubMedCrossRef Zalavras CG, Vartholomatos G, Dokou E, Malizos KN. Genetic background of osteonecrosis: associated with thrombophilic mutations? Clin Orthop Relat Res. 2004;422:251–5.PubMedCrossRef
40.
41.
go back to reference Gagala J, Buraczynska M, Mazurkiewicz T, Ksiazek A. Endothelial nitric oxide synthase gene intron 4 polymorphism in non-traumatic osteonecrosis of the femoral head. Int Orthop. 2013;37(7):1381–5.PubMedCentralPubMedCrossRef Gagala J, Buraczynska M, Mazurkiewicz T, Ksiazek A. Endothelial nitric oxide synthase gene intron 4 polymorphism in non-traumatic osteonecrosis of the femoral head. Int Orthop. 2013;37(7):1381–5.PubMedCentralPubMedCrossRef
42.
go back to reference Koo KH, Lee JS, Lee YJ, Kim KJ, Yoo JJ, Kim HJ. Endothelial nitric oxide synthase gene polymorphisms in patients with nontraumatic femoral head osteonecrosis. J Orthop Res Off Publ Orthop Res Soc. 2006;24(8):1722–8.CrossRef Koo KH, Lee JS, Lee YJ, Kim KJ, Yoo JJ, Kim HJ. Endothelial nitric oxide synthase gene polymorphisms in patients with nontraumatic femoral head osteonecrosis. J Orthop Res Off Publ Orthop Res Soc. 2006;24(8):1722–8.CrossRef
43.
go back to reference He W, Li K. Incidence of genetic polymorphisms involved in lipid metabolism among Chinese patients with osteonecrosis of the femoral head. Acta Orthop. 2009;80(3):325–9.PubMedCentralPubMedCrossRef He W, Li K. Incidence of genetic polymorphisms involved in lipid metabolism among Chinese patients with osteonecrosis of the femoral head. Acta Orthop. 2009;80(3):325–9.PubMedCentralPubMedCrossRef
44.
go back to reference Hauzeur JP, Pasteels JL, Schoutens A, Hinsenkamp M, Appelboom T, Chochrad I, et al. The diagnostic value of magnetic resonance imaging in non-traumatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 1989;71(5):641–9.PubMed Hauzeur JP, Pasteels JL, Schoutens A, Hinsenkamp M, Appelboom T, Chochrad I, et al. The diagnostic value of magnetic resonance imaging in non-traumatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 1989;71(5):641–9.PubMed
45.
go back to reference Markisz JA, Knowles RJ, Altchek DW, Schneider R, Whalen JP, Cahill PT. Segmental patterns of avascular necrosis of the femoral heads: early detection with MR imaging. Radiology. 1987;162(3):717–20.PubMedCrossRef Markisz JA, Knowles RJ, Altchek DW, Schneider R, Whalen JP, Cahill PT. Segmental patterns of avascular necrosis of the femoral heads: early detection with MR imaging. Radiology. 1987;162(3):717–20.PubMedCrossRef
46.
go back to reference Mitchell DG, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Steinberg ME, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology. 1987;162(3):709–15.PubMedCrossRef Mitchell DG, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Steinberg ME, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology. 1987;162(3):709–15.PubMedCrossRef
47.
go back to reference Steinberg DR, Steinberg ME. The University of Pennsylvania classification of osteonecrosis. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 201–6. Steinberg DR, Steinberg ME. The University of Pennsylvania classification of osteonecrosis. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 201–6.
48.
go back to reference Ha YC, Jung WH, Kim JR, Seong NH, Kim SY, Koo KH. Prediction of collapse in femoral head osteonecrosis: a modified Kerboul method with use of magnetic resonance images. J Bone Joint Surg Am. 2006;88 Suppl 3:35–40.PubMedCrossRef Ha YC, Jung WH, Kim JR, Seong NH, Kim SY, Koo KH. Prediction of collapse in femoral head osteonecrosis: a modified Kerboul method with use of magnetic resonance images. J Bone Joint Surg Am. 2006;88 Suppl 3:35–40.PubMedCrossRef
49.
go back to reference Malizos KN, Karantanas AH, Varitimidis SE, Dailiana ZH, Bargiotas K, Maris T. Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol. 2007;63:16–28.PubMedCrossRef Malizos KN, Karantanas AH, Varitimidis SE, Dailiana ZH, Bargiotas K, Maris T. Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol. 2007;63:16–28.PubMedCrossRef
50.
go back to reference Stevens K, Tao C, Lee SU, Salem N, Vandevenne J, Cheng C, et al. Subchondral fractures in osteonecrosis of the femoral head: comparison of radiography, CT, and MR imaging. Am J Roentgenol. 2003;180(2):363–8.CrossRef Stevens K, Tao C, Lee SU, Salem N, Vandevenne J, Cheng C, et al. Subchondral fractures in osteonecrosis of the femoral head: comparison of radiography, CT, and MR imaging. Am J Roentgenol. 2003;180(2):363–8.CrossRef
51.
go back to reference Korompilias AV, Karantanas AH, Lykissas MG, Beris AE. Transient osteoporosis. J Am Acad Orthop Surg. 2008;16(8):480–9.PubMed Korompilias AV, Karantanas AH, Lykissas MG, Beris AE. Transient osteoporosis. J Am Acad Orthop Surg. 2008;16(8):480–9.PubMed
53.
go back to reference Szwedowski D, Nitek Z, Walecki J. Evaluation of transient osteoporosis of the hip in magnetic resonance imaging. Pol J of Radiol Pol Med Soc Radiol. 2014;79:36–8. Szwedowski D, Nitek Z, Walecki J. Evaluation of transient osteoporosis of the hip in magnetic resonance imaging. Pol J of Radiol Pol Med Soc Radiol. 2014;79:36–8.
54.
go back to reference Ikemura S, Yamamoto T, Motomura G, Nakashima Y, Mawatari T, Iwamoto Y. The utility of clinical features for distinguishing subchondral insufficiency fracture from osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2013;133(12):1623–7.PubMedCrossRef Ikemura S, Yamamoto T, Motomura G, Nakashima Y, Mawatari T, Iwamoto Y. The utility of clinical features for distinguishing subchondral insufficiency fracture from osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2013;133(12):1623–7.PubMedCrossRef
56.
go back to reference Yoon PW, Kwak HS, Yoo JJ, Yoon KS, Kim HJ. Subchondral insufficiency fracture of the femoral head in elderly people. J Korean Med Sci. 2014;29(4):593–8.PubMedCentralPubMedCrossRef Yoon PW, Kwak HS, Yoo JJ, Yoon KS, Kim HJ. Subchondral insufficiency fracture of the femoral head in elderly people. J Korean Med Sci. 2014;29(4):593–8.PubMedCentralPubMedCrossRef
57.
go back to reference Mont MA, Marulanda GA, Jones LC, Saleh KJ, Gordon N, Hungerford DS, et al. Systematic analysis of classification systems for osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 Suppl 3:16–26.PubMedCrossRef Mont MA, Marulanda GA, Jones LC, Saleh KJ, Gordon N, Hungerford DS, et al. Systematic analysis of classification systems for osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88 Suppl 3:16–26.PubMedCrossRef
58.
go back to reference Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br Vol. 1985;67(1):3–9. Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br Vol. 1985;67(1):3–9.
59.
go back to reference Gardeniers J. A new international classification of osteonecrosis of the ARCO committee on terminology and classification. ARCO Newsl. 1992;4(4):41–6. Gardeniers J. A new international classification of osteonecrosis of the ARCO committee on terminology and classification. ARCO Newsl. 1992;4(4):41–6.
60.
go back to reference Ono K. Diagnostic criteria, staging system and roentgenographic classification of avascular necrosis of the femoral head (steroid induced, alcohol associated or idiopathic nature) (in Japanese) Annual report of Japanese investigation committee for intractable disease, avascular necrosis of the femoral head. Tokyo: Ministry of health and Welfare; 1987. Ono K. Diagnostic criteria, staging system and roentgenographic classification of avascular necrosis of the femoral head (steroid induced, alcohol associated or idiopathic nature) (in Japanese) Annual report of Japanese investigation committee for intractable disease, avascular necrosis of the femoral head. Tokyo: Ministry of health and Welfare; 1987.
61.
go back to reference Sugano N, Atsumi T, Ohzono K, Kubo T, Hotokebuchi T, Takaoka K. The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci Off J Jpn Orthop Assoc. 2002;7(5):601–5. Sugano N, Atsumi T, Ohzono K, Kubo T, Hotokebuchi T, Takaoka K. The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci Off J Jpn Orthop Assoc. 2002;7(5):601–5.
62.
go back to reference Kerboul M, Thomine J, Postel M, Merle d'Aubigne R. The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. J Bone Joint Surg Br Vol. 1974;56(2):291–6. Kerboul M, Thomine J, Postel M, Merle d'Aubigne R. The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. J Bone Joint Surg Br Vol. 1974;56(2):291–6.
63.
go back to reference Koo KH, Kim R. Quantifying the extent of osteonecrosis of the femoral head. A new method using MRI. J Bone Joint Surg Br Vol. 1995;77(6):875–80. Koo KH, Kim R. Quantifying the extent of osteonecrosis of the femoral head. A new method using MRI. J Bone Joint Surg Br Vol. 1995;77(6):875–80.
64.
go back to reference Nam KW, Kim YL, Yoo JJ, Koo KH, Yoon KS, Kim HJ. Fate of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 2008;90(3):477–84.PubMedCrossRef Nam KW, Kim YL, Yoo JJ, Koo KH, Yoon KS, Kim HJ. Fate of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 2008;90(3):477–84.PubMedCrossRef
65.
go back to reference Steinberg ME, Bands RE, Parry S, Hoffman E, Chan T, Hartman KM. Does lesion size affect the outcome in avascular necrosis? Clin Orthop Relat Res. 1999;367:262–71.PubMed Steinberg ME, Bands RE, Parry S, Hoffman E, Chan T, Hartman KM. Does lesion size affect the outcome in avascular necrosis? Clin Orthop Relat Res. 1999;367:262–71.PubMed
66.
go back to reference Banerjee S, Kapadia BH, Jauregui JJ, Cherian JJ, Mont MA. Natural history of osteonecrosis. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 161–4. Banerjee S, Kapadia BH, Jauregui JJ, Cherian JJ, Mont MA. Natural history of osteonecrosis. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 161–4.
67.
go back to reference Cheng EY. Osteonecrosis of the femoral head. The North American perspective. In: Bulstrode D, Buckwalter J, Carr A, Marsh L, Fairbank J, Wilson-MacDonald J, editors. Oxford textbook of orthopaedics and trauma. Oxford: Oxford University Press; 2002. p. 981–91. Cheng EY. Osteonecrosis of the femoral head. The North American perspective. In: Bulstrode D, Buckwalter J, Carr A, Marsh L, Fairbank J, Wilson-MacDonald J, editors. Oxford textbook of orthopaedics and trauma. Oxford: Oxford University Press; 2002. p. 981–91.
68.
go back to reference Mont MA, Zywiel MG, Marker DR, McGrath MS, Delanois RE. The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg Am. 2010;92(12):2165–70.PubMedCrossRef Mont MA, Zywiel MG, Marker DR, McGrath MS, Delanois RE. The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg Am. 2010;92(12):2165–70.PubMedCrossRef
69.
go back to reference Sugano N, Takaoka K, Ohzono K, Matsui M, Masuhara K, Ono K. Prognostication of nontraumatic avascular necrosis of the femoral head. Significance of location and size of the necrotic lesion. Clin Orthop Relat Res. 1994;303:155–64.PubMed Sugano N, Takaoka K, Ohzono K, Matsui M, Masuhara K, Ono K. Prognostication of nontraumatic avascular necrosis of the femoral head. Significance of location and size of the necrotic lesion. Clin Orthop Relat Res. 1994;303:155–64.PubMed
70.
go back to reference Cherian SF, Laorr A, Saleh KJ, Kuskowski MA, Bailey RF, Cheng EY. Quantifying the extent of femoral head involvement in osteonecrosis. J Bone Joint Surg Am. 2003;85-A(2):309–15.PubMed Cherian SF, Laorr A, Saleh KJ, Kuskowski MA, Bailey RF, Cheng EY. Quantifying the extent of femoral head involvement in osteonecrosis. J Bone Joint Surg Am. 2003;85-A(2):309–15.PubMed
71.
go back to reference Sugano N, Ohzono K. Natural Course and the JIC Classification of Osteonecrosis of the Femoral Head. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 207–10. Sugano N, Ohzono K. Natural Course and the JIC Classification of Osteonecrosis of the Femoral Head. In: Koo KH, Mont MA, Jones LC, editors. Osteonecrosis. Heidelberg: Springer; 2014. p. 207–10.
72.
go back to reference Arlet J, Ficat RP. Forage-biopsie de la tete femorale dans I'osteonecrose primitive. Observations histopathologiques portant sur huit forances. Rev Rheum. 1964;31(31):257–64. Arlet J, Ficat RP. Forage-biopsie de la tete femorale dans I'osteonecrose primitive. Observations histopathologiques portant sur huit forances. Rev Rheum. 1964;31(31):257–64.
73.
go back to reference Gardeniers J. ARCO committee on terminology and staging. A new proposition of terminology and an international classification of osteonecrosis. ARCO Newsl. 1991;3(3):153–9. Gardeniers J. ARCO committee on terminology and staging. A new proposition of terminology and an international classification of osteonecrosis. ARCO Newsl. 1991;3(3):153–9.
74.
go back to reference Gardeniers J. ARCO Committee on Terminology and Staging. Report on the committee meeting at Santiago de Compostella. ARCO Newsl. 1993;5(5):79–82. Gardeniers J. ARCO Committee on Terminology and Staging. Report on the committee meeting at Santiago de Compostella. ARCO Newsl. 1993;5(5):79–82.
Metadata
Title
Osteonecrosis of the femoral head: diagnosis and classification systems
Authors
Ho-Rim Choi
Marvin E. Steinberg
Edward Y. Cheng
Publication date
01-09-2015
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 3/2015
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-015-9278-7

Other articles of this Issue 3/2015

Current Reviews in Musculoskeletal Medicine 3/2015 Go to the issue

Modern Surgical Treatment of Hip Avascular Necrosis (MA Mont, Section Editor)

Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head—a current review

Gunshot Wounds and Blast Injuries (D Stinner and MK Sethi, Section Editors)

High velocity gunshot injuries to the extremities: management on and off the battlefield

Gunshot Wounds and Blast Injuries (D Stinner and MK Sethi, Section Editors)

Blurred front lines: triage and initial management of blast injuries

Gunshot Wounds and Blast Injuries (D Stinner and MK Sethi, Section Editors)

Gunshot-induced fractures of the extremities: a review of antibiotic and debridement practices

Modern Surgical Treatment of Hip Avascular Necrosis (MA Mont, Section Editor)

Imaging evaluation of patients with osteonecrosis of the femoral head

Modern Surgical Treatment of Hip Avascular Necrosis (MA Mont, Section Editor)

Treatment of osteonecrosis of the femoral head with vascularized bone grafting