AVASCULAR OSTEONECROSIS OF THE FEMORAL-HEAD TREATED WITH A VASCULARIZED ILIAC BONE-GRAFT - PRELIMINARY-RESULTS AND FOLLOW-UP WITH RADIOGRAPHY AND MR-IMAGING

Treatment of avascular necrosis (AVN) of the femoral head with a vascu larized iliac bone graft was studied in nine patients (12 hips). The c ondition of the femoral head was classified radiographically before an d after surgery. Magnetic resonance (MR) imaging was performed to demo nstrate the extent and signal intensity characteristics of the area of AVN and to assess the viability of the graft. The radiologic results were correlated with the clinical findings. Although radiography showe d progression of disease in six patients, seven of the nine patients d emonstrated clinical improvement. The MR imaging results correlated be tter with the clinical findings: MR imaging demonstrated progression o f AVN in only two patients (two hips) and no progression or reduced ne crosis in six patients (nine hips). Nine of the ii grafts (eight patie nts) evaluated with MR imaging appeared viable after a mean follow-up of 50 months. MR imaging appears useful in assessing marrow changes an d graft viability after treatment of AVN of the femoral head with a va scularized iliac bone graft.