ArticleInternational orthopaedics2018
Subchondral fracture begins from the bone resorption area in osteonecrosis of the femoral head: a micro-computerised tomography study.
Article in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 44 citations in OpenAlex.
- Cell therapy versus simultaneous contralateral decompression in symptomatic corticosteroid osteonecrosis: a thirty year follow-up prospective randomized study of one hundred and twenty five adult patients.International orthopaedics · 2018Trial
- Stem cell therapy in bilateral osteonecrosis: computer-assisted surgery versus conventional fluoroscopic technique on the contralateral side.International orthopaedics · 2018Trial
- A Stage-Based, Multidisciplinary Approach to Therapy-Associated Osteonecrosis in Pediatric Oncology Patients.Journal of the Pediatric Orthopaedic Society of North America · 2026Review
- Review
- Japan's contributions to hip joint preservation and reconstruction: from osteonecrosis and developmental dysplasia to precision arthroplasty.International orthopaedics · 2026Review
- Application of additive manufacturing TaBw01 porous tantalum rod in ARCO stage II osteonecrosis of the femoral head.Journal of orthopaedic surgery and research · 2024Article
- Three-dimensional distribution of subchondral fracture lines in osteonecrosis of the femoral head.Journal of orthopaedic translation · 2024Article
- Cycloastragenol prevents bone loss via inhibiting osteoclast activity in glucocorticoid-induced osteonecrosis of the femoral head: AnJournal of orthopaedic translation · 2024Article
- CT and MRI findings beyond the subchondral bone in osteonecrosis of the femoral head to distinguish between ARCO stages 2 and 3A.European radiology · 2023Article
- Sclerotic zone in femoral head necrosis: from pathophysiology to therapeutic implications.EFORT open reviews · 2023Review
- The Role of Structural Deterioration and Biomechanical Changes of the Necrotic Lesion in Collapse Mechanism of Osteonecrosis of the Femoral Head.Orthopaedic surgery · 2022Review
- An injectable self-adaptive polymer as a drug carrier for the treatment of nontraumatic early-stage osteonecrosis of the femoral head.Bone research · 2022Article
- Evolutionary course of the femoral head osteonecrosis: Histopathological - radiologic characteristics and clinical staging systems.Journal of orthopaedic translation · 2022Review
- Collapse-Related Bone Changes in Osteonecrotic Femoral Heads at Multidetector CT: Comparison between Femoral Heads with Limited and Advanced Collapse.Journal of the Belgian Society of Radiology · 2022Article
- Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study.Open medicine (Warsaw, Poland) · 2022Article
- Lateral pillar is the key in supporting pre-collapse osteonecrosis of the femoral head: a finite element model analysis of propensity-score matched cohorts.Journal of orthopaedic surgery and research · 2021Article
- Activation of cannabinoid receptor 2 alleviates glucocorticoid-induced osteonecrosis of femoral head with osteogenesis and maintenance of blood supply.Cell death & disease · 2021Article
- Three-Dimensional Distribution of Bone-Resorption Lesions in Osteonecrosis of the Femoral Head Based on the Three-Pillar Classification.Orthopaedic surgery · 2021Article
- [Clinical significance of different imaging manifestations of osteonecrosis of femoral head in the peri-collapse stage].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2021Article
- Long-term outcomes of curved intertrochanteric varus osteotomy combined with bone impaction grafting for non-traumatic osteonecrosis of the femoral head.The bone & joint journal · 2021Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFor successful joint preservation in osteonecrosis of the femoral head (ONFH), it is important to understand the mechanism of collapse. The purpose of this study was to investigate the initiation of subchondral fracture in ONFH by using micro-CT imaging of the whole femoral head, focusing on the three-dimensional relationship between the subchondral fracture and the bone resorption area.
methodsA total of 40 femoral heads from 37 patients retrieved during total hip arthroplasty for stage 3A or 3B ONFH by Japanese Investigation Committee criteria were scanned using micro-CT with a 0.146-mm thickness cuts. We divided the cohort into early and late collapsed stages according to a threshold of 3 mm of collapse as measured by micro-CT.
resultsAccording to the analysis on multiple radial plane views in the whole femoral head, there were two interesting findings. First, the initial fracture cracks ran between separated bone resorption areas at the anterosuperior portions of all 18 femoral heads in the early collapsed stage. Second, fractures of the necrotic bone at the sclerotic boundary and a fibrous, granulation-like, low-density tissue along the necrotic side of the sclerotic boundary were seen in 19 of the 22 in the late collapsed stage. After bone resorption around the retinaculum and teres insertion initiates the subchondral fracture, bone resorption expanding at the anterosuperior portion of the femoral head may result in the spread of fracture and the potential for massive collapse.
conclusionsThree-dimensional micro-CT showed bone resorption around the reparative zone initiates the subchondral fracture in ONFH.
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