康复科新文献报告(中英文版)
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髋臼负重区分为3部分，依据坏死部位的JIC股骨头坏死分型示意图：A型坏死不超出 内1/3；B型坏死不超出中1/3；C1型袁坏死不超出髋臼缘；C2型坏死超出髋臼缘。
Schematic diagram and MRI
China-Japan Friendship Hospital (CJFH) Classification for ONFH based on three pillars.
necrosis that subchondral bone have been remained partly. The former have a good prognosis while the latter is poor. The foundation of new classification is the research of two types of osteonecrosis that is on change of imaging and prognosis.
A 40 year old male with steroid-associated bone infarction, the MRI showed necrosis involved only in bone marrow: (a)Sagittal image of the femur and tibia (b)Transverse image of the shaft of femur (c)Transverse image of the tibiofibula
head Etc.) called osteonecrosis.
There are two types: 1.The necrosis of bone marrow merely
(Bone infarction). 2. The bone marrow necrosis or bone cortical
中日友好医院依三柱结构对股骨头坏死的分型
China-Japan Friendship Hospital (CJFH) classification for osteonecrosis of the femoral head based on three pillars.
Type A(medial): The necrosis involved the medial pillar, retain the central and lateral pillar.
Lateral accounted for 30% Central accounted for 40% Medial accounted for 30%
股骨头冠状面三柱结构： 外侧柱占 30%， 中央柱占 40%， 内侧柱占 30%。
lateral central medial
The necrosis occured in extremities (Femoral head, Humerus
股骨头缺血性坏死是骨科常见的难治性疾病，它的特点是股骨头的微细 结构逐渐受到侵蚀、破坏。如果在股骨头缺血性坏死早期阶段未采取有效 的治疗，股骨头将在1-5年内塌陷。最终患者只能接受人工髋关节置换术。
Mont MA, Jones LC, Hungerford DS. Nontraumatic osteonecrosis of the femoral head: ten years later. J Bone Joint Surg Am, 2006, 88(5): 1117-1132.
MRI（2003）示右侧股骨头坏死为皮质存留、骨髓坏死，左侧坏死为皮质及 骨髓均坏死。
Three (2006) and Six year (2009) later , The CT scan showed the right femoral head kept round, but collapse occurred in the left femoral head
--China Japan Friendship Hospital (CJFH) classification
(LI Zi-rong etc.)
基于三柱结构的股骨头坏死分型
-中日友好医院分型
Chin J Orthop, June 2012, Vol. 32, No.6
Osteonecrosis of the femoral head(ONFH) is a disease that is common and refractory in orthopaedics .It is characterized by a deterioration of the micro architecture of femoral head. It will be round into collapse of the femoral head in 1-5 years, if the effective treatment not be taken in the early stage of ONFH.Finally, the patient have to accept a hip replacement surgery.
New literature report
新文献报告
Rehabilitation Department Zhangtian
康复科 张田
Title
The classification of osteonecrosis of the femoral head based on the three
pillars structure
将股骨头冠状面分成三柱（内、中、外），选择MRI或者CT的冠状位正中 层面图像，按坏死灶占据三柱结构的位置分型。应用此分型及日本分型（JIC ）分别对153髋SARS股骨头坏死患者的自然转归及100髋保存自身关节手术的 疗效进行回顾性研究，以比较两种分型的准确度。
The three pillars of coronal section of femoral head:
三年后（2006年）及6年后（2009年），CT扫描示右侧股骨头维持圆 形，骨皮质完整，但中央坏死灶未修复；左侧股骨头塌陷
Schematic diagram of Japanese Investigation Committee (JIC) classification for osteonecrosis of the femoral head. The weight-bearing zone of acetabulum is divided into three portions：Type A means the necrosis doesn't exceed the medial one-third. Type B means the necrosis doesn't exceed the central one-third. Type C1 means the necrosis doesn't exceed the edge of the acetabulum. Type C2 means the necrosis exceeds the edge of the acetabulum.
Let's go through the following two cases
发生在骨端（股骨Байду номын сангаас、肱骨头等)的坏死，称为骨坏死。 骨坏死有两种类型：1、单纯骨髓坏死又称为骨梗死；2、软骨下骨（皮 质骨）部分保留的骨髓坏死或皮质坏死。两种类型的骨坏死有不同的结 局：前者预后较好，后者预后差。研究两种类型骨坏死的影像学改变及 预后是建立新分型的基础。
However,The long-term efficacy of hip replacement surgery in young patients is still unclear. So the delay or avoid artificial hip replacement is a deserved researching, that can make many patients keep the joint function within the time as long as possible.
The most important factors that affect hip function is prevent the collapse of the femoral head, hence, the prediction of collapse has always been a hot topic in this field. The method are many, but all have some limitations and further improvement. So the purpose of our study is to analyze the pattern of development of nontraumatic ONFH combined with the observation of imaging, In order to establish the new reliable and convenient classification(CJFH).
In this paper, the cases still using ARCO staging, the new classification does not involve the stage of femoral head necrosis.
然而年轻患者的人工关节置换长期疗效仍不明确。因此推迟或避免人工关节置换，使尽可能多 的患者在尽可能长的时间内保持自身的关节功能是非常值得研究的课题。
影响关节功能的最重要因素是防止股骨头塌陷，因此塌陷预测一直是这一领域研究的热点和难 点。预测塌陷的方法很多，但都有一定的局限性和进一步改进的空间。因此本研究的目的是通过 对非创伤性股骨头坏死进展规律的分析结合影像学观察，创建简便可信的股骨头坏死分型新方法。
文内研究病例仍采用ARCO分期法，此分型不涉及股骨头坏死分期。
Material and methods
The coronal section of the femoral head was divided into three pillars (medial, central and lateral). The midcoronal section on MRI or CT was selected. The classification was determined according to site where the three pillars was occupied by necrotic focus. The retrospective studies were carried out in natural history of 153 SARS patients with ONFH and treatment results of 100 hips with joint-preserving operation using both CJFH and JIC classification.
男，40岁，激素性骨梗死，MRI显示坏死仅累及骨髓，皮质存留：（a）股骨干和胫骨干矢 状位图像；(b）股骨干横断面图像；（c）胫腓骨横断面图像。
A 53 year old male with steroid-associated necrosis of the femoral head, MRI(2003) showed necrosis in bone marrow not in cortical bone in right side, but necrosis of both cortical bone and marrow in left side.
Schematic diagram and MRI
China-Japan Friendship Hospital (CJFH) Classification for ONFH based on three pillars.
necrosis that subchondral bone have been remained partly. The former have a good prognosis while the latter is poor. The foundation of new classification is the research of two types of osteonecrosis that is on change of imaging and prognosis.
A 40 year old male with steroid-associated bone infarction, the MRI showed necrosis involved only in bone marrow: (a)Sagittal image of the femur and tibia (b)Transverse image of the shaft of femur (c)Transverse image of the tibiofibula
head Etc.) called osteonecrosis.
There are two types: 1.The necrosis of bone marrow merely
(Bone infarction). 2. The bone marrow necrosis or bone cortical
中日友好医院依三柱结构对股骨头坏死的分型
China-Japan Friendship Hospital (CJFH) classification for osteonecrosis of the femoral head based on three pillars.
Type A(medial): The necrosis involved the medial pillar, retain the central and lateral pillar.
Lateral accounted for 30% Central accounted for 40% Medial accounted for 30%
股骨头冠状面三柱结构： 外侧柱占 30%， 中央柱占 40%， 内侧柱占 30%。
lateral central medial
The necrosis occured in extremities (Femoral head, Humerus
股骨头缺血性坏死是骨科常见的难治性疾病，它的特点是股骨头的微细 结构逐渐受到侵蚀、破坏。如果在股骨头缺血性坏死早期阶段未采取有效 的治疗，股骨头将在1-5年内塌陷。最终患者只能接受人工髋关节置换术。
Mont MA, Jones LC, Hungerford DS. Nontraumatic osteonecrosis of the femoral head: ten years later. J Bone Joint Surg Am, 2006, 88(5): 1117-1132.
MRI（2003）示右侧股骨头坏死为皮质存留、骨髓坏死，左侧坏死为皮质及 骨髓均坏死。
Three (2006) and Six year (2009) later , The CT scan showed the right femoral head kept round, but collapse occurred in the left femoral head
--China Japan Friendship Hospital (CJFH) classification
(LI Zi-rong etc.)
基于三柱结构的股骨头坏死分型
-中日友好医院分型
Chin J Orthop, June 2012, Vol. 32, No.6
Osteonecrosis of the femoral head(ONFH) is a disease that is common and refractory in orthopaedics .It is characterized by a deterioration of the micro architecture of femoral head. It will be round into collapse of the femoral head in 1-5 years, if the effective treatment not be taken in the early stage of ONFH.Finally, the patient have to accept a hip replacement surgery.
New literature report
新文献报告
Rehabilitation Department Zhangtian
康复科 张田
Title
The classification of osteonecrosis of the femoral head based on the three
pillars structure
将股骨头冠状面分成三柱（内、中、外），选择MRI或者CT的冠状位正中 层面图像，按坏死灶占据三柱结构的位置分型。应用此分型及日本分型（JIC ）分别对153髋SARS股骨头坏死患者的自然转归及100髋保存自身关节手术的 疗效进行回顾性研究，以比较两种分型的准确度。
The three pillars of coronal section of femoral head:
三年后（2006年）及6年后（2009年），CT扫描示右侧股骨头维持圆 形，骨皮质完整，但中央坏死灶未修复；左侧股骨头塌陷
Schematic diagram of Japanese Investigation Committee (JIC) classification for osteonecrosis of the femoral head. The weight-bearing zone of acetabulum is divided into three portions：Type A means the necrosis doesn't exceed the medial one-third. Type B means the necrosis doesn't exceed the central one-third. Type C1 means the necrosis doesn't exceed the edge of the acetabulum. Type C2 means the necrosis exceeds the edge of the acetabulum.
Let's go through the following two cases
发生在骨端（股骨Байду номын сангаас、肱骨头等)的坏死，称为骨坏死。 骨坏死有两种类型：1、单纯骨髓坏死又称为骨梗死；2、软骨下骨（皮 质骨）部分保留的骨髓坏死或皮质坏死。两种类型的骨坏死有不同的结 局：前者预后较好，后者预后差。研究两种类型骨坏死的影像学改变及 预后是建立新分型的基础。
However,The long-term efficacy of hip replacement surgery in young patients is still unclear. So the delay or avoid artificial hip replacement is a deserved researching, that can make many patients keep the joint function within the time as long as possible.
The most important factors that affect hip function is prevent the collapse of the femoral head, hence, the prediction of collapse has always been a hot topic in this field. The method are many, but all have some limitations and further improvement. So the purpose of our study is to analyze the pattern of development of nontraumatic ONFH combined with the observation of imaging, In order to establish the new reliable and convenient classification(CJFH).
In this paper, the cases still using ARCO staging, the new classification does not involve the stage of femoral head necrosis.
然而年轻患者的人工关节置换长期疗效仍不明确。因此推迟或避免人工关节置换，使尽可能多 的患者在尽可能长的时间内保持自身的关节功能是非常值得研究的课题。
影响关节功能的最重要因素是防止股骨头塌陷，因此塌陷预测一直是这一领域研究的热点和难 点。预测塌陷的方法很多，但都有一定的局限性和进一步改进的空间。因此本研究的目的是通过 对非创伤性股骨头坏死进展规律的分析结合影像学观察，创建简便可信的股骨头坏死分型新方法。
文内研究病例仍采用ARCO分期法，此分型不涉及股骨头坏死分期。
Material and methods
The coronal section of the femoral head was divided into three pillars (medial, central and lateral). The midcoronal section on MRI or CT was selected. The classification was determined according to site where the three pillars was occupied by necrotic focus. The retrospective studies were carried out in natural history of 153 SARS patients with ONFH and treatment results of 100 hips with joint-preserving operation using both CJFH and JIC classification.
男，40岁，激素性骨梗死，MRI显示坏死仅累及骨髓，皮质存留：（a）股骨干和胫骨干矢 状位图像；(b）股骨干横断面图像；（c）胫腓骨横断面图像。
A 53 year old male with steroid-associated necrosis of the femoral head, MRI(2003) showed necrosis in bone marrow not in cortical bone in right side, but necrosis of both cortical bone and marrow in left side.