Abstract
1. In two-month-old rabbits the femoral heads were made necrotic by transecting the ligament of the femoral head and applying a ligature around the femoral neck. The animals were killed at different periods, from six hours to twenty-one weeks after the operation. The changes in the femoral heads were studied histologically, microradiographically and radiographically.
2. In the first three weeks the necrotic bone marrow was penetrated by granulation tissue in which cellular differentiation gradually developed. Subsequently large quantities of new bone were deposited on the dead trabeculae. This led to an increase in the bone volume at the expense of the marrow volume; this increase coincided with an increase in the radiographic density (sclerosis) of the femoral head. The new bone tissue was attached to the necrotic trabeculae by a specific cement line and showed the features of woven bone. At a later stage lamellar bone was deposited. From six weeks on a normal bone-marrow ratio was gradually restored with concomitant radiographic loss of sclerosis.
3. It is suggested that mechanical weakening of the femoral head is the consequence of this late post-operative restoration of the normal pre-operative bone-to-marrow ratio, the new bone trabeculae being mechanically inferior because of the presence of woven bone and cement lines. This weakness may initiate collapse and deformation of the revascularised femoral head.
