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Lateral pillar preservation linked with lower risk of femoral collapse in osteonecrotic cases
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Osteonecrotic progression to femoral collapse is less likely to occur in patients with more preserved lateral pillars regardless of whether patients underwent either joint-preserving or conservative therapy, according to a recently published study.
“The authors concluded that whether osteonecrosis of the femoral head progressed to collapse is determined by preservation of the lateral pillar,” the authors wrote in the abstract. “The lateral pillar is the keystone for maintaining the sphere of the femoral head and its preservation.”
The authors compared patients with osteonecrosis of the femoral head (ONFH) who underwent conservative therapy to patients who underwent joint-preserving therapy at their institution.
The 42 patients in the conservative group received medication and had 3 months of physical therapy. The group included 26 men and 61 women with an average age of 33 years. There were 37 Association for Research in Osseous Circulation (ARCO) type I hips, Most patients in this group had Association for Research in Osseous Circulation (ARCO) type II and III hips.
In the joint-preserving group, there were 19 men and 23 women with an average age of 30.7 years. For this group surgeons debrided necrotic bone and applied impacted bone graft with autogenous iliac and artificial bone. Most patients in the group had ARCO type II and III hips.
Overall, patients with the most osteonecrosis in the lateral pillar had a higher collapse rate and a shorter time to collapse.
Disclosures: The authors have no relevant financial relationships to disclose. The study was supported by the National Natural Science Foundation of China (81372013) and the Research Fund of China-Japan Friendship Hospital (2013-MS-27).
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