Related Experiment Video
Updated: Jun 17, 2026
06:17
Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
Published on: April 12, 2022
Osteonecrosis following resurfacing arthroplasty
Gösta Ullmark1, Kent Sundgren, Jan Milbrink
1Department of Orthopedics, Gävle Hospital and Center for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden. gosta.ullmark@lg.se
Acta Orthopaedica
|December 10, 2009
Summary
Positron emission tomography with [18F]-fluoride (Fluoride-PET) detects osteonecrosis after hip resurfacing. Three patients developed significant femoral head osteonecrosis within a year, undetected by X-rays.
Area of Science:
- Orthopedic surgery
- Nuclear medicine
- Bone metabolism
Background:
- Hip resurfacing arthroplasty raises concerns about femoral head viability and fracture risk.
- Radiographic methods cannot assess bone viability beneath metal components.
- Positron emission tomography ([18F]-fluoride or Fluoride-PET) visualizes bone viability.
Purpose of the Study:
- To evaluate Fluoride-PET's utility in assessing bone viability after hip resurfacing.
- To identify early signs of osteonecrosis not visible on radiographs.
Main Methods:
- Prospective study of 14 patients undergoing ASR resurfacing arthroplasty.
- Clinical, radiographic, and Fluoride-PET scans at 1 week, 4 months, and 1 year post-surgery.
Main Results:
- One patient showed minor osteonecrosis at 1 week and 4 months, progressing to involve most of the head by 1 year.
- Two patients developed extensive osteonecrosis by 1 year, initially appearing normal at 4 months.
- A fourth patient had minor osteonecrosis at 1 year.
- No clinical symptoms or radiographic evidence of osteonecrosis were observed in affected patients.
Conclusions:
- Fluoride-PET is a sensitive method for evaluating bone metabolism post-hip resurfacing.
- Three of 14 patients developed significant osteonecrosis within one year.
- The late onset suggests vascularity is not solely due to surgical damage.
- The complication's late appearance and radiographic invisibility are concerning.
Related Concept Videos
01:31Osteoclasts in Bone Remodeling
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...
01:40Bone Remodeling
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...