PMC4756222_01
(a) Anteroposterior radiograph obtained 4 years before arthroscopic surgery. A sclerotic band is apparent in both femoral heads. (b) Multiplanar reconstruction via computed tomography at the same time show a herniation pit at the junction of the femoral head and neck (asterisk), in addition to the obvious sclerotic band in the femoral head (black arrow). (c and d) T1-weighted magnetic resonance images show a bone marrow edema pattern that indicates collapse of the femoral head in the head and neck of the left femur (white arrow).
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In January 2007, he underwent hemiarthroplasty of his left hip joint at another hospital because of bilateral alcoholic ONFH, according to the criteria described by Steinberg et al. (left: stage 3A; right: stage 2C) and the criteria described by Sugano et al. (left: type C1, stage 3A; right: type B, stage 2) (Fig. 1).
(a) Anteroposterior radiograph obtained just before the arthroscopic surgery. Sclerotic band and herniation pit was more obvious than 4 years ago. (b) Multiplanar reconstruction of computed tomographic image showing no obvious collapse of the femoral head. (c) Bone scintigraphy demonstrated cold in hot pattern as seen in primary osteonecrosis and no increased uptake due to collapse. (d) Arthro-MRI showing intensity change of anterolateral part of the labrum which indicates labral tear (white arrow).
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A plain radiograph showed slight joint-space narrowing, a sclerotic band in the femoral head, cam deformity, and a large herniation pit in the femoral head-neck junction (Fig. 2).
Anteroposterior radiographs taken (a) 4 years before the arthroscopic surgery, (b) just before surgery, (c) immediately after surgery, and (d) 3 years after surgery. No obvious progression of joint-space narrowing has been seen in the 7 years.
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We found that the anterolateral portion of the labrum was torn (Fig. 3).