Three-dimensional classification and collapse prediction in osteonecrosis of the femoral head based on China-Japan Friendship Hospital classification

doi:10.3969/j.issn.2095-4344.0256

Abstract

Abstract:

BACKGROUND: Predictive accuracy of collapse of the femoral head is strongly associated with the classification of osteonecrosis of the femoral head (ONFH). The China-Japan Friendship Hospital (CJFH) classification of ONFH based on three pillars is sensitive in predicting collapse of the femoral head, but it is only analyzed in two dimensions. There is little reported on the three-dimensional classification based on the CJFH classification.

OBJECTIVE: To investigate the advantage of the three-dimensional classification of the three pillars structure and the value of its prediction of collapse in ONFH by establishing the new classification.

METHODS: The MRI and CT data of 106 hips (68 cases) diagnosed as ONFH were selected. The femoral head was divided into a medial, central and lateral three-pillars structure three-dimensionally in accordance with the CJFH classification. Three-dimensional CJFH (3D-CJFH) was established based on the size and location of the necrotic area and the three-dimensional classification. All 106 hips were classified according to 3D-CJFH classification and CJFH classification, respectively. The collapse rates of the different types were obtained and compared between the two classifications.

RESULTS AND CONCLUSION: (1) 3D-CJFH classification was composed of type A (the medial type), type B (the central type) and type C (the lateral type), amongst which the type C consisted of type C₁ (all pillars were involved with some normal in lateral pillar), type C₂ (the whole lateral pillars and partial central pillar) and type C₃ (the whole femoral head). (2) The collapse rates of type A (5.6%), type B (8.0%) and type C (58.7%) of 3D-CJFH classification were different, and the collapse rates of type C₁ (25.0%), type C₂ (75.0%) and type C₃ (96.3%) of this classification were also different. Similarly, the collapse rates of type A (5.3%), type B (13.8%) and type C (59.3%) of CJFH classification were different, and the collapse rates of type C₁ (32.3%), type C₂ (75.0%) and type C₃(95.7%) of CJFH classification were also different. (3) The collapse rates of type A and C₃ in 3D-CJFH classification were higher than that in CJFH classification. The collapse rates of type B and C₁ in 3D-CJFH classification were lower than that in 3D-CJFH classification after comparison. The collapse rate of type C₂ in the two classifications revealed no statistically significant difference. The collapse rate of type C in 3D-CJFH classification was lower compared with that in 3D-CJFH classification. (4) The results in this study demonstrate that prediction results of femoral head collapse are similar between 3D-CJFH and CJFH classifications, but the former is more consistent with the 3D biomechanical properties of femoral head. 3D-CJFH classification paves ways for three-dimensional diagnosis and prediction of femoral head collapse for necrosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femur Head Necrosis, Imaging, Three-Dimensional, Tissue Engineering

CLC Number:

R318

Zhou Si-jia, Jiang Wen-xue. Three-dimensional classification and collapse prediction in osteonecrosis of the femoral head based on China-Japan Friendship Hospital classification[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(19): 3033-3038.

Figures/Tables 4

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