2023, Vol. 27 ›› Issue (31): 4996-5001

Distribution law and pathological characteristics of cystic degeneration in steroid-induced femoral head necrosis

Tian Jiaqing1, He Mincong2, 3, Wei Yurou1, He Xianshun1, Zhong Yuan1, Jiang Yulai1, Zhan Zhiwei1, Wei Tengfei1, He Xiaoming2, 3, Wei Qiushi2, 3   

Abstract: BACKGROUND: The reduction of mechanical bearing capacity of the femoral head is the main cause of femoral head collapse, and cystic degeneration affects the normal mechanical conduction pathway of the hip joint. However, few studies have explored the relationship between the two in the development of femoral head necrosis.
OBJECTIVE: To discuss the distribution law and pathological characteristics of cystic degeneration in steroid-induced femoral head necrosis based on heat map model and pathological results.
METHODS: Thirty patients (30 hips) who were diagnosed with steroid-induced femoral head necrosis in the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from June to December 2021 were selected as the research objects, and the outline of cystic degeneration of steroid-induced femoral head necrosis was extracted and the contour line was matched to the standard femoral head model to present the contour line as a heat map. Necrosis position and necrosis area of the femoral head were recorded and counted to study the relationship between the two. Hematoxylin-eosin staining was used for histomorphological changes of femoral head specimens.
RESULTS AND CONCLUSION: (1) Based on the heat map of the cystic degeneration of steroid-induced femoral head necrosis and the pathological results of the femoral head, we found that cystic degeneration commonly occurred in the medial and lateral columns of the femoral head after steroid-induced femoral head necrosis. Compared with the area of cystic degeneration of the medial column, the area of cystic degeneration of the lateral column was larger, and with the inward movement of cystic degeneration, its area also decreased. (2) In addition, microfracture lines were scattered around cystic degeneration, which may be one of the important factors affecting the mechanical bearing capacity and stability of the femoral head.

Key words: steroid-induced femoral head necrosis, cystic degeneration, heat map, microfracture, mechanical bearing capacity, distribution law, pathological characteristics