Analysis On The Correlation Between Joint Effusion And Stage Of Necrosis And Joint Function In Nontraumatic Osteonecrosis Of Femoral Head

BACKGROUND:Currently,the number of study for joint effusion of femoral head necrosis is still less,but the progression of nontraumatic osteonecrosis of the femoral head is often accompanied by the changes in joint effusion,and whether joint effusion can cause the change of the hip score and it's relationship with the necrosis stage is not clear.OBJECTIVE: To explore the correlation between the joint effusion and stage of necrosis and joint function in nontraumatic osteonecrosis of femoral head(NONFH),so as to understand the effection of joint effusion in NONFH,to further clarify the clinical significance of joint effusion in the course of the evolution of NONFH.METHODS: we collected 46 cases(74 hips)of nontraumatic osteonecrosis of the femoral head patients treated in the First Affiliated Hospital of Anhui Medical University Between January 2013 to January 2016.18 cases of single hip,28 cases of double hips.The joint effusion of hip was diagnosised by MRI T2 weighted images and T2 fat suppression images,and were graded to 4 according to the joint effusion classification method proposed by Mitchell.According to the ARCO staging criteria,nontraumatic osteonecrosis of the femoral head was divided into 4,Harris score criteria was used to score the hip joint function and was graded to 4.Then,we filled in the relevant statistics tabl and analyzed the correlation of joint effusion with ARCO staging and Harris Score Grade.RESULTS: There were 65 hips joint effusion occurred among 74 hips of femoral head necrosis?ARCO stage correlated with joint effusion grading(r=0.50,P<0.001),The results showed significant difference in joint effusion grading among these necrosis stagings(?2=24.81,P<0.001).With the advance of necrosis from stage?to?,the joint effusion grading increased gradually.The average rank of joint effusion in stage IV was less than stage III.the average rank in stage?to ? were as followed respectively: ? 15.79;? 33.22;? 48.43;? 44.71.Harris score grading correlated with joint effusion grading(r=0.52,P<0.001),The results of showed significant difference in 44.71?joint effusion grading among these Harris gradings(?2=21.97,P<0.001).With the decrease of Harris score,the joint effusion grading and the average rank increased gradually,the results were as followed respectively: excellent 18.85,good 33.37,fair 36.95,poor 54.44.CONCLUTION:The incidence of joint effusion is correlated significantly with stage of necrosis and Harris score in NONFH.the increase of the joint effusion grade indicates the aggravation of osteonecrosis of the femoral head disease,and the function decrease of hips.To a certain extent,this study suggests that joint effusion can be used as an auxiliary indicator to predict the occurrence and progression of disease.