TO THE EDITOR:
In “The Natural History of Untreated Asymptomatic Hips in Patients Who Have Non-Traumatic Osteonecrosis” (79-A: 359–363, March 1997), Jergesen and Khan made a valiant attempt to sort out meaningful clinical data related to a disease entity that continues to be a source of considerable controversy. The authors are to be commended on the completeness of the follow-up for most of their study group. However, since they cited the work of both Kerboul et al.2 and Ohzono et al.3, who delineated size and location factors that have an impact on the progression of the disease, it is surprising that Jergesen and Khan did not include an evaluation of these factors in their analysis. The combined angle described by Kerboul et al. and the locations described by Ohzono et al. can be determined for all stage-II and stage-III lesions. Both Kerboul et al. and Ohzono et al. used radiographic methods to demarcate the extent and location of a lesion although they are not as accurate as localization with magnetic resonance imaging.
In contradistinction to many other authors, Jergesen and Khan concluded that most asymptomatic radiographically evident lesions (ten of nineteen in their study) in patients who have a symptomatic contralateral hip will not …
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