gms | German Medical Science

Objectives: This purpose of this retrospective study was to discuss the efficacy of joint-preserving treatment for Osteonecrosis of the femoral head (ONFH) using an X-ray based evaluation, WJXE, approach.

Methods: The WJXE method consists of two steps: (1) the first step requires quantitation of the following 3 radiographic findings: femoral head depression; necrosis area and osteoarthritis; (2) the second step converts the quantitation points into score for evaluation purposes.

1.

The quantitation of the radiographic findings are as follows: table01

2.

The following scoring system is adopted for evaluation purposes, the quantitation of the 3 radiographic findings is converted into a single point respectively and summed up to a single score. The maximum point for femoral head depression, necrosis area and Osteoarthritis is 3, 3 and 4 point respectively. The sum of the 3 points generate a single maximum score of 10 where the higher score indicates a more severe condition.

Results: The above method was used to evaluate 50 hips from joint-preserving treatment. The femoral head depression score before treatment is 0.6, and 3 months, 1 year and 3 years follow up is 0.59, 0.78 and 1.04 respectively. The necrosis area score before treatment is 3, and 3 months, 1 year and 3 years follow up is 0.51, 0.45, 0.26 respectively. The Osteoarthritis score before treatment is 0.08, and 3 months, 1 year and 3 years follow up is 0.08, 0.26, 0.86 respectively. The total score of the 3 radiographic findings before treatment is 3.68, and 3 months, 1 year and 3 years follow up is 1.18, 1.49 2.16 respectively.

Conclusions: The WJXE approach has provide a reproducible method to use X-ray radiographic findings to evaluate the efficacy of joint-preserving for ONFH.