Predicting the collapse of the femoral head due to osteonecrosis: From basic methods to application prospects

Collapse of the femoral head is the most significant pathogenic complication arising from osteonecrosis of the femoral head. It is related to the disruption of the maintenance of cartilage and bone, and results in an impaired function of the vascular component. A method for predicting the collapse of the femoral head can be treated as a type of clinical index. Efforts in recent years to predict the collapse of the femoral head due to osteonecrosis include multiple methods of radiographic analysis, stress distribution analysis, finite element analysis, and other innovative methods. Prediction methods for osteonecrosis of the femoral head complications originated in Western countries and have been further developed in Asia. Presently, an increasing number of surgeons have chosen to focus on surgical treatments instead of prediction methods to guide more conservative interventions, resulting in a growing reliance on the more prevalent and highly effective total hip arthroplasty, rather than on more conservative treatments. In this review, we performed a literature search of PubMed and Embase using search terms including “osteonecrosis of femoral head,” “prediction,” “collapse,” “finite element,” “radiographic images,” and “stress analysis,” exploring the basic prediction method and prospects for new applications.