| Prediction of posttraumatic femoral head osteonecrosis by quantitative intraosseous aspirate and core biopsy analysis: A prospective study | | 2010, N° 4 (Vol. 76/4) p.486-492 | | Ramesh Kumar Sen, Sujit Kumar Tripathy, Shivinder Singh Gill, Neelam Verma, Paramjeet Singh, Bishan Dass Radotra | | From the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India |
| | Abstract: | | Twenty-two patients with unreduced hip dislocation or fracture dislocation were prospectively evaluated. Intraosseous aspiration, marrow fluid analysis and core biopsy histological analysis was performed from the supero-lateral (test group) and central part (control group) of the femoral head. After appropriate surgical treatment and postoperative management, they were followed up for 2 years by clinical, radiological and magnetic resonance imaging evaluation. Eight patients eventually developed avascular necrosis (AVN) of the femoral head. The analysis of test samples revealed that 9 patients had an aspirate volume of <1cc ; marrow morphology of 11 hips showed necrotic cells ; 12 patients had a core biopsy histology suggestive of dead osseous fragments and necrotic osteocytes. In contrast, all the control samples had an aspirate volume of >1cc and showed viable cells on histology. Intra-operative assessment of marrow-aspirate volume (<1cc), marrow morphology and core biopsy histology from the superolateral part of femur head can fairly predict the development of subsequent ONFH after trauma ; the correlation is statistically significant (p<0.05). |
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