and osteoarthritis of the hip.
Kiaer-T; Pedersen-NW; Kristensen-KD; Starklint-H
J-Bone-Joint-Surg-Br. 1990 Nov; 72(6): 1023-30
AB: The intra-osseous pressure, PO2, and PCO2 were measured in 32 hips
(21 patients) which were painful but showed no severe degenerative
changes. Pre-operative scintigraphy and radiography was performed in
all patients. Thirteen hips showed early osteoarthritis, eight had
early osteonecrosis, and 11 had no changes. Core biopsies were
performed and the bone was examined histologically and graded for
necrosis. Histologically, necrosis was present in 27 specimens.
Scintigraphic findings did not correlate with the histological results
but were more closely related to the radiographic findings. The
intra-osseous pressure in hips with histological necrosis (mean 47
mmHg) was significantly higher than in hips without necrosis (mean 26
mmHg). The PO2 was lower in bone with histological necrosis (mean 44
mmHg) than in bone without (mean 71 mmHg). PO2 increased and
intra-osseous pressure decreased after decompression. The results
confirm that ischaemia plays a central role in the development of
necrotic changes in bone. Histological necrosis was found in hips with
radiographic signs of osteonecrosis and in those with osteoarthritis.
Radiography, and scintigraphy are shown to be insensitive methods for
differentiating between those disorders.