Systematization of the Radiologic-Morphometric Parameters of Acetabular Area during Femoral Head Aseptic Necrosis

A.V. Altanets, A.E. Oleinyk, E.A. Kovbasa, A.E. Loskutov


There is still no data regarding correlation between the femoral head aseptic necrosis staging and the total hip endoprosthesis construction demonstrating the best clinical outcomes. Absence of the single approach to the acetabular component type selection based on the present classification principles determines the necessity for the identification and grouping of the acetabular area condition’s roentgen-morphometric criteria. This gives an opportunity to objectify the optimal acetabular component type selection abstracted from the hip head aseptic necrosis sta­ging framework. Based on the radiologic-morphometric analysis there were detected series of criteria describing the acetabular and the supraacetabular area conditions, which give an opportunity to draw the deformation patterns requiring the differentiated acetabular component type selection. There were identified five morpho-implantation groups. Analysis of the biomechanical conditions, formed in each of the group allows justifying the correct acetabular component type application in order to achieve durable endoprosthesis stability.


total hip replacement; aseptic necrosis; acetabulum; radiologic morphometry


Korzh M.O. Pro klasifіkacіju aseptichnogo nekrozu golovki stegnovoї kіstki. / M.O. Korzh, A.E. Vishnjakov // Ortopedija, travmatologija i protezirovanie. – 2009. - №- 3. – S.116-120.

Loskutov A.E. Ocenka sostojanija vertluzhnoj vpadiny pri asepticheskom nekroze goovki bedrennoj kosti po dannym rentgenmorfometricheskih issledovanij / A.E Loskutov, A.E. Olejnik, A.V. Altanec // Travma – 2014. – T. 15, №1. – S.82-88.

Mihajlova N.M. Idiopaticheskij asepticheskij nekroz golovki bedrennoj kosti u vzros-lyh / N.M. Mihajlova, M.I. Malova - M.: Medicina. - 1982. - 136 s.

Peredumovi rozvitku aseptichnoї nestabіl'nostі total'nogo bezcementnogo endoproteza kul'shovogo sugloba (biomehanіchne ta matematichne modeljuvannja) / G.V. Gajko, V.M. Pіdgaєc'kij, O.M. Sulima, O.V.Chkalov // Ortopedija, travmatologija i protezirovanie. – 2009 - №1 – C.10-17.

Tihilov R.M. Rukovodstvo po jendoprotezirovaniju tazobedrennogo sustava/ R.M. Tihilov; pod red. R.M. Tihilova, V.M. Shapovalova. - Spb.: RNIITO im. R.R.Vredena, 2008. – 324 c.

Arlet J. Nontraumatic avascular necrosis of the femoral head. Past, present and future. Clin Orthop Relat Res 1992; 277:12-21.

Bombelli R. Radiological Pattern of the Normal Hip Joint and its Biomechanical Meaning. In: Draenert K., Rutt A. Morphologie und Function der Hufte. Histo-Morph Bewen-gungsapp. 1981; 1:113-138.

Effenberger H, Bohm G, Huber M. Experimental study of bone-implant contact area with a parabolic acetabular component (Hofer-Imhof). Arch Orthop Trauma Surg 2000; 120:160-165.

Ficat RP. Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J Bone Joint Surg 1985; 67 B:3-9.

Fritsche A, Bialek K, Mittelmeier W. Experimental investigations of the insertion and deformation behavior of press-fit and threaded acetabular cups for total hip replacement. J Orthop Sci 2008; 13:240–247. doi 10.1007/s00776-008-1212-z.

Engh CH, Zettl-Schaffer KF, Kukita Y. Histological and radiografic assessment of well-functioning porous-coated acetabular components. J Bone Joint Surg Am 1993; 75:814-824.

Johannson HR, Zywiel MG, Marker DR. Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Inter Orthop (SICOT) 2011; 35:465–473. doi 10.1007/s00264-010-0979-7.

Lieberman JR, Berry DJ, Mont MA. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect 2003; 52:337-355.

Konstantinos NM, Apostolos HK, Socratis EV. Osteonecrosis of the femoral head: etiology, imaging and treatment. Europ Journ Radiology 2007; 63:16-28. doi:10.1016/j.ejrad.2007.03.019.

Issa K, Pivec R, Kapadia BH, Banerjee S. Osteonecrosis of the femoral head. The total hip replacement solution J Bone Joint Surg 2013; 95-B:46–50. doi: 10.1302/0301-620X.95B11.32644.

Pauwels F. Atlas Zur Biomechanik der gesunden und kranken Hufte. Berlin, Heidelberg, New York: Springer, 1973.

Philips A. Finite element analysis of the acetabulum after impaction grafting. University of Edinburgh, 2001: 13-17.

Stulberg BN, Singer R, Goldner J. Uncemented total hip arthroplasty in osteonecrosis. A 2- to 10-year evaluation. Clin Orthop 1997; 334:116-123.

Mont MA, Seyler TM, Plate JF, Delanois RE Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am 2006; 88-A: 104–109. doi: 10.2106/JBJS.F.00451.

Witzel U. Distriburion of stress in a hemispherical RM cup and its bony bed. In: Bergmann EG Hip-joint surgery, the RM cup. Reinbek, Einhorn-Presse Verlag, 1998:29-41.

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