Given the advent of new surgical approaches to the hip joint,
new treatment options for young patients with femoral head necrosis (AVN) have emerged.
However using current diagnostic standard technqiues for MRI accurate detection of pattern of necrosis and femoral cartilage damage is difficult.
we aimed to assess (1) location of necrosis,
(2) location and pattern of femoral cartilage damage,
(3) diagnostic accuracy to detect femoral cartilage lesions using direct,
Methods and Materials
IRB-approved retrospective study.
The institutional database (2016-2018,
360 hips) was reviewed for patients with AVN and complete radiographs and direct,
traction MRA of the hip at 3T.
Thirty patients were included (mean age 31 ± 9 years,
Hips were staged according to the ARCO classification (0,
Fourteen (47%) hips underwent joint preserving surgery (10 open,
Traction technique included weight-adapted traction (15-23 kg),
(1) Necrosis was located most frequently in the antero-superior quadrant (93% of hips) (Fig.
1). (2) Most frequently femoral cartilage delamination was found in the antero-superior quadrant (87% of hips) (Fig.
2). (3) Sensitivity was 93% (25/27),
specificity was 100% (29/29) of traction MRA to detect femoral cartilage lesions (Fig.
AVN predominantly affects the antero-superior quadrant and leads to corresponding femoral cartilage delamination which can be detected accurately using traction MRA.
Characterization of necrosis,
resulting cartilage damage pattern provides valuable information for planning of intra-articular surgery in young patients with AVN.