Pathology of femoral head collapse following transtrochanteric rotational osteotomy for osteonecrosis

Citation
T. Nakai et al., Pathology of femoral head collapse following transtrochanteric rotational osteotomy for osteonecrosis, ARCH ORTHOP, 120(9), 2000, pp. 489-492
Citations number
8
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
ISSN journal
0936-8051 → ACNP
Volume
120
Issue
9
Year of publication
2000
Pages
489 - 492
Database
ISI
SICI code
0936-8051(200008)120:9<489:POFHCF>2.0.ZU;2-#
Abstract
We investigated the pathology of femoral head collapse following transtroch anteric anterior rotational osteotomy. Six femoral heads were obtained duri ng total hip arthroplasty some 2-12 years after osteotomy. In all cases, th e preoperatively necrotic lesions exhibited mostly osteonecrosis with accum ulation of bone marrow cell debris and trabecular bone with empty lacunae, although repair tissue such as granulation tissue and appositional bone for mation were observed in Limited areas in some cases. In the transposed inta ct articular surface of the femoral head, osteoarthritic changes such as fi ssure penetration to the subchondral bone and osteophyte formation were com monly observed. In newly created subchondral areas at weight-bearing sites, trabecular thickness and the number of trabecular bones had decreased, wit h few osteoblasts, osteoclasts, and osteocytes being present, resulting in a coarse lamellar structure of the trabecular bone. These findings suggest that transposed areas in cases of failure consist mostly of low-turnover os teoporotic lesions which could cause collapse of the femoral head.