Assessment of Acetabulum State in Avascular Necrosis of the Femoral Head According to Data of Roentgenomorphometry Studies

A.Ye. Loskutov, A.Ye. Oleynik, A.V. Altanets

Abstract


In this article the comparative roentgenomorphometry analysis of the acetabulum deformity formation in avascular necrosis of the femoral head (ANFN) was carried out to determine the criteria conditioning the choice of construction of endoprosthesis acetabular component. There was done an analysis of radiographs of 339 acetabular joints of patients with ANFN made in a direct projection. Radiographs were divided into 3 groups depending on the stage of the process: II stage — 18 radiographs, III stage — 116; IV stage — 205. When analyzing acetabular state, the following characteristics were evaluated: sphericity coefficient of the acetabulum α (α = r/d, where r — acetabular radius, d — acetabular diameter), the proportionality coefficient β (β = n/r, where n — thickness of acetabular floor), suitability coefficient γ (γ = h/r, where h — the height of «Napoleon hat»). The following trends were revealed: in the early stages of ANFN (II–III) the structure and form of acetabulum was not significantly different from normal values, but with initial signs of destruction in the III stage. In IV stage there’s a clearly apparent lowering of the supraacetabular zone height, in 18 % — destruction of the upper sections, in 16.4 % — protrusion in the acetabular floor, as well as other destructive changes of acetabulum. This causes the need for an individual approach to the selection of the type of acetabular component of endoprosthesis by analyzing roentgenomorphometry criteria of acetabulum.


Keywords


avascular necrosis of the femoral head; roentgenomorphometry; acetabulum

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DOI: https://doi.org/10.22141/1608-1706.1.15.2014.81282

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