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Table 1 Preoperative stages of the 71 hips classified according to the Steinberg's classification system.

From: Indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head

Stage

Characteristics

Number of Hips

0

Normal radiographs, bone scan, and MR images

0

I

Normal radiographs, abnormal bone scan, and MR images

 

   A: mild

< 15% of head involvement

0

   B: moderate

15% to 30%

2

   C: severe

> 30%

1

II

Abnormal radiograph

 

   A: mild

< 15% of head involvement

1

   B: moderate

15% to 30%

3

   C: severe

> 30%

24

III

Subchondral collapse producing a crescent sign

 

   A: mild

< 15% of articular surface

0

   B: moderate

Crescent beneath 15% to 30%

1

   C: severe

Crescent beneath > 30%

2

IV

  

   A: mild

< 15% of surface collapsed and depression is < 2 mm

2

   B: moderate

15% to 30% collapsed or 2 to 4 mm depression

8

   C: severe

> 30% collapsed or > 4 mm depression

24

V

Joint narrowing with or without acetabular involvement

 

   A, B, or C

Average of femoral head involvement, as determined in Stage an d estimated acetabular involvement

3

VI

Advanced degenerative changes

0