RELATIONSHIP BETWEEN THE REPAIR VASCULATURE AND THE SIZE OF NECROSIS IN NON-TRAUMATIC OSTEONECROSIS OF THE FEMORAL HEAD
Kajiwara T, Atsumi T, Hiranuma Y, Toshima J, Tamaoki S, Asahua Y
Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama Japan

We have performed selective angiography of the nutrient arteries of the femoral head to study the hemodynamics of osteonecrosis of the femoral head. The results indicate that the area of demarcation is supplied by the vasculature derived from not only the superior retinacular artery (SRA) but also the inferior retinacular artery (IRA). When compared to patients in whom the SRA transversed beyond the weight-bearing region of the femoral head into the internal regions, the volume of necrosis tended to be larger in those patients in whom the SRA did not transverse beyond the weight-bearing region of the femoral head. These data suggested that the vessels participating in the repair process in response to ischemia of the femoral head are the SRA as well as the IRA, and that the pattern of the repair vasculature derived from the SRA is a determinant of the size of the necrosis of this disease.