Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (36): 5827-5831.doi: 10.12307/2021.350

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Correlation between the retention angle of the anterior and lateral wall of the femoral head and the progression of the femoral head collapse

Yan Xinhao1, 2, Pang Fengxiang1, 2, Zhong Yuan3, 4, Chen Xiaojun1, 2, He Xiaoming1, 2, Hong Zhinan2, 3, Li Ziqi2, 3, Luo Zhihong1, 2, He Wei2, 3, Wei Qiushi2, 3#br#   

  1. 1First Clinical Medical College, 2Hip Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 3Department of Arthritis, Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, Guangdong Province, China; 4Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510080, Guangdong Province, China
  • Received:2020-12-28 Revised:2020-12-30 Accepted:2021-02-07 Online:2021-12-28 Published:2021-09-18
  • Contact: Wei Qiushi, MD, Associate TCM chief physician, Hip Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; Department of Arthritis, Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510378, Guangdong Province, China
  • About author:Yan Xinhao, master, First Clinical Medical College, and Hip Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:
     the National Natural Science Foundation of China (General Program), No. 81873327 (to HW); the Science and Technology Development Project of Guangdong Province, No. 2017B090912007 (to HW)

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Abstract: BACKGROUND: At present, many methods are used to predict the collapse of femoral head after necrosis in clinical practice, with the purpose of providing reference for the selection of subsequent treatment methods. However, the current prediction methods are not accurate enough or practical in clinical practice. This has also prompted more researchers in the field of femoral head necrosis to search for a way to assess the risk of femoral head collapse.  
OBJECTIVE: To evaluate the correlation between the preservation of the anterior and lateral wall of the femoral head and the progression of femoral head collapse.
METHODS:  Data of 53 patients (76 hips) with osteonecrosis of the femoral head (stages ARCO II and ARCO III A) undergoing non-surgical hip preservation treatment, who were diagnosed in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from August 2012 to February 2019, were retrospectively analyzed. The retention angle of the anterior and lateral wall of the femoral head was measured on the X-ray imaging system to analyze the correlation between retention angle and collapse. The specificity and sensitivity of the angle in predicting collapse were evaluated by receiver operating characteristic curve.  
RESULTS AND CONCLUSION: (1) All cases were followed up clinically for 3-83 months. During the last follow-up, 27 hips (36%) affected femoral head collapse as the collapse group; 49 hips (64%) that did not affect collapse were classified as non-collapse group. (2) The results of independent sample t-test showed that the retention angle of anterior and lateral wall was significantly correlated with collapse. (3) In receiver operating characteristic curve, the retention angle of the anterior and lateral wall of the femoral head had high specificity and sensitivity. (4) It was found that patients with osteonecrosis of the femoral head with small retention angle of the anterior and lateral wall were more likely to collapse, indicating that there was a certain correlation between the retention angle of the anterior and lateral wall of the femoral head and the progression of collapse of the femoral head. Therefore, this angle can be used as a reference index for collapse prediction to some extent.

Key words: osteonecrosis of femoral head, retention angle of anterior wall, retention angle of lateral wall, collapse prediction, femoral head collapse

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