Imperial College London
Alternate

MrMichaelPearse

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 8846 1473m.pearse

 
 
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Location

 

ICTEM buildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Calder:2008:10.1302/0301-620X.90B2.19593,
author = {Calder, JD and Hine, AL and Pearse, MF and Revell, PA},
doi = {10.1302/0301-620X.90B2.19593},
journal = {J Bone Joint Surg Br},
pages = {154--158},
title = {The relationship between osteonecrosis of the proximal femur identified by MRI and lesions proven by histological examination.},
url = {http://dx.doi.org/10.1302/0301-620X.90B2.19593},
volume = {90},
year = {2008}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Total hip replacement in patients with advanced osteonecrosis of the femoral head is often complicated by early loosening of the femoral component. Recent evidence has suggested that abnormal bone extending into the proximal femur may be responsible for the early failure of the femoral component. We aimed to identify which patients were at high risk of early failure by evaluating gadolinium-enhanced MR images of histologically-confirmed osteonecrotic lesions beyond the femoral head. Although the MR signal intensity has been shown to correlate well with osteonecrosis in the femoral head, it was found to be relatively insensitive at identifying lesions below the head, with a sensitivity of only 51% and a predictive value of a negative result of only 48%. However, the specificity was 90%, with the predictive value of a positive MRI finding being 86%. Only those patients with osteonecrosis of the femoral head secondary to sickle-cell disease, who are known to be at high risk of early loosening, had changes in the MR signal in the greater trochanter and the femoral shaft. This observation suggests that changes in the MR signal beyond the femoral head may represent osteonecrotic lesions in areas essential for the fixation of the femoral component. Pre-operative identification of such lesions in the neck of the femur may be important when considering hip resurfacing for osteonecrosis of the femoral head, following which early loosening of the femoral component and fracture of the neck are possible complications.
AU  - Calder,JD
AU  - Hine,AL
AU  - Pearse,MF
AU  - Revell,PA
DO  - 10.1302/0301-620X.90B2.19593
EP  - 158
PY  - 2008///
SP  - 154
TI  - The relationship between osteonecrosis of the proximal femur identified by MRI and lesions proven by histological examination.
T2  - J Bone Joint Surg Br
UR  - http://dx.doi.org/10.1302/0301-620X.90B2.19593
UR  - https://www.ncbi.nlm.nih.gov/pubmed/18256080
VL  - 90
ER  -
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