title: MRI-guidance in percutaneous core decompression of osteonecrosis of the femoral head.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the usefulness of MRI-guidance for core decompression of avascular necrosis of the femoral head.
  
  
  METHODS
  Twelve MRI-guided core decompressions were performed on patients with different stages of avascular necrosis of the femoral head. The patients were asked to evaluate their pain and their ability to function before and after the procedure and imaging findings were reviewed respectively.
  
  
  RESULTS
  Technical success in reaching the target was 100 % without complications. Mean duration of the procedure itself was 54 min. All patients with ARCO stage 1 osteonecrosis experienced clinical benefit and pathological MRI findings were seen to diminish. Patients with more advanced disease gained less, if any, benefit and total hip arthroplasty was eventually performed on four patients.
  
  
  CONCLUSIONS
  MRI-guidance seems technically feasible, accurate and safe for core decompression of avascular necrosis of the femoral head. Patients with early stage osteonecrosis may benefit from the procedure.
  
  
  CONCLUSIONS
  • MRI is a useful guidance method for minimally invasive musculoskeletal interventions. • Bone drilling seems beneficial at early stages of avascular necrosis. • MRI-guidance is safe and accurate for bone drilling.
authors.affiliation: Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland. pekka.kerimaa@ppshp.fi.
authors.forename: Pekka
authors.identifier: http://orcid.org/0000-0002-2754-4791
authors.initials: P
authors.lastname: Kerimaa
authors.affiliation: Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Väänänen
authors.affiliation: Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland.
authors.forename: Risto
authors.initials: R
authors.lastname: Ojala
authors.affiliation: Department of Surgery, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Hyvönen
authors.affiliation: Department of Surgery, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Lehenkari
authors.affiliation: Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland.
authors.forename: Osmo
authors.initials: O
authors.lastname: Tervonen
authors.affiliation: Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029, Oulu, OYS, Finland.
authors.forename: Roberto
authors.initials: R
authors.lastname: Blanco Sequeiros
mesh_terms: D000328:Adult; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005270:Femur Head / Q000473:pathology / Q000601:surgery; D005271:Femur Head Necrosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013812:Therapeutics; D016896:Treatment Outcome; D055815:Young Adult
keywords: Core decompression; Femur; Interventional MRI; Musculoskeletal; Osteonecrosis