Study Of MRI On Curative Effect Of Osteonecrosis Of Femoral Head And Treatment For Removing Stasis

Objects: It is critical to choose suitable cases with intensive knowledge if preserving treatment is considered. On osteonecrosis of femoral head, MRI is used for diagnosing early, judging site and extent of lesion. Now that MRI represents the character of tissue well, this study is to find more information by MRI for clinical decision. Methods: Review cases with osteonecrosis of femoral head during 2003 to 2004. All cases are treated with preserving-operation and Sheng mai cheng gu serial medicine. Before operation, classify cases by X-ray representation based on ARCO classification and observe whether there is sclerosis band. Evaluate MRI representation: (1) segregation condition: transfixation band, segregation between cartilage and bone, segregation between bone and bone;(2) four stages of pathologic classification based on MRI signal character;(3) texture in weight bearing zone;(4) add Bone Marrow Edema(BME) score and joint effusion score as stasis index. Evaluate effects by reviewing follow-up X-rays.Results: This study shows cases in middle stage have worse effect, which has significant difference (p<0.05). The more serious stasis is, the worse result the case has, which has significant difference(p<0.05). Unstable texture is connected with worse result, which has significant difference(p<0.05). While alcohol group show more incidence of segregation between bone and cartilage than steroid group, but there is no significant difference (p>0.05). Furthermore, there is no significant difference between the groups with sclerosis band;the groups with different operations in ARCO III stage and the groups with different preserving operations in middle stage of MRI signal character.Conclusions: This study suggests that common MRI can show the progress of repair and unstable condition, which is connected with the prognosis. BME and effusion in MRI is some kind of reference for Traditional Chinese Medicine treatment based on stasis theory. It is practical to prognosis and treat ONFH based on syndrome differentiation referring to MRI signal character.