ArticleJournal of orthopaedic surgery and research2026
Prognostic impact of preoperative MRI on core decompression in ARCO stage III osteonecrosis of the femoral head: a retrospective cohort study.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManaging ARCO stage III osteonecrosis of the femoral head (ONFH) is controversial, as surgeons choose between joint preservation and arthroplasty. While MRI provides superior assessment of lesion geometry compared with radiographs and may theoretically allow more precise targeting for debridement, it remains unclear whether preoperative MRI-based trajectory planning improves hip survival after core decompression in ARCO Stage III disease compared with pure fluoroscopic guidance. Obtaining an additional MRI solely to determine the three-dimensional location of the lesion prior to core decompression may impose financial and time burdens without adding significant value to treatment. This study aimed to determine whether the absence of timely three-dimensional imaging has an impact on the prognosis of patients with ARCO Stage III disease undergoing core decompression.
methodsThis study retrospectively analyzed patients with ARCO stage III ONFH who underwent core decompression between 2010 and 2023 at a single institution. The hips were categorized into MRI-guided group and X-ray-guided group based on the availability of preoperative MRI. The primary outcome was the rate of conversion total hip arthroplasty at one, two and five years. Secondary outcomes included visual analogue scale (VAS) and Harris Hip Score (HHS).
resultsA total of 241 hips in 207 patients were included in the analysis and were categorized into MRI-guided group (114 hips) and X-ray-guided group (127 hips). Overall survival at one, two, and five years was 70.5%, 57.3%, and 46.5%, respectively. Among stage IIIa hips, five-year survival was higher in the X-ray-guided group than in the MRI-guided group (62.8% vs. 41.9%, P = 0.036). In stage IIIb, outcomes were poor and comparable between groups (34.7% vs. 37.5%).There was no difference in conversion-free-survival between MRI-guided and X-ray-guided group at last follow-up. Postoperative VAS and HHS improved significantly in both groups, with no intergroup differences.
conclusionPreoperative MRI availability did not significantly influence survival following core decompression, THA conversion, or functional outcomes in ARCO stage III ONFH. X-ray-guided core decompression may be a feasible treatment option for stage III ONFH when radiographic diagnosis is evident, particularly in settings with limited MRI accessibility. LEVEL OF EVIDENCE: Level III, retrospective cohort study.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.