Modern View on Pathogenesis of Non Traumatic Osteonecrosis

Non traumatic osteonecrosis of the femoral head is one of the leading causes of hip function loss in young patients. At the late stages of this disease the only way to restore motor activity is total hip arthroplasty. Literature review presents the systematic analysis of the most significant causes of this disease (long-term intake of corticosteroids, alcohol abuse, thrombophilia). Pathogenetic mechanisms of femoral head vascularization disturbance are considered. In recent decades the fundamental genetic studies enabled to establish that pathogenesis of femoral head osteonecrosis is based on the polymorphisms of genes that ensure coagulation cascade, and angiogenesis disturbance.

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Epidemiological Study of Femoral Head Osteonecrosis

Revista de Chimie ◽

10.37358/rc.17.5.5593 ◽

2017 ◽

Vol 68 (5) ◽

pp. 974-976

Author(s):

Alexandru Patrascu ◽

Liliana Savin ◽

Dan Mihailescu ◽

Victor Grigorescu ◽

carmen Grierosu ◽

...

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Head Group ◽

Bipolar Hemiarthroplasty ◽

Aseptic Necrosis ◽

Total Hip ◽

Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

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Long-term results of transtrochanteric rotational osteotomy for femoral head osteonecrosis

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/bf00434538 ◽

1996 ◽

Vol 115 (3-4) ◽

pp. 127-130 ◽

Cited By ~ 22

Author(s):

P. Grigoris ◽

M. Safran ◽

I. Brown ◽

H. C. Amstutz

Keyword(s):

Femoral Head ◽

Long Term Results ◽

Rotational Osteotomy ◽

Transtrochanteric Rotational Osteotomy ◽

Femoral Head Osteonecrosis

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No increased stem subsidence after arthroplasty in young patients with femoral head osteonecrosis:41 patients followed for 1–9 years

Acta Orthopaedica ◽

10.1080/17453670610013141 ◽

2006 ◽

Vol 77 (6) ◽

pp. 866-870 ◽

Cited By ~ 11

Author(s):

Akif Ince ◽

Johannes Lermann ◽

Sascha Göbel ◽

Nicole Wollmerstedt ◽

Christian Hendrich

Keyword(s):

Femoral Head ◽

Young Patients ◽

Stem Subsidence ◽

Femoral Head Osteonecrosis

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Osteonecrosis of the Femoral Head in an Adolescent on Long-Term Inhalational Corticosteroids

Case Reports in Pediatrics ◽

10.1155/2017/6969787 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Anthony C. Egger ◽

R. Tracy Ballock

Keyword(s):

Case Report ◽

Femoral Head ◽

Inhaled Corticosteroids ◽

Delayed Diagnosis ◽

Oral Steroid ◽

Systemic Corticosteroids ◽

Femoral Head Osteonecrosis ◽

Usual Case ◽

Short Courses

A relationship between the development of osteonecrosis of the femoral head and systemic corticosteroids has been well established in the literature, particularly in adults. However, the link between osteonecrosis and inhaled corticosteroids is less researched and understood. We report an usual case report of a 10-year-old male who developed ipsilateral femoral head osteonecrosis after long-term inhalational corticosteroid and intermittent short courses of oral steroid usage with a unique presentation and delayed diagnosis.

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Cementless Total Hip Arthroplasty With Alumina-on-Highly Cross-Linked Polyethylene Bearing in Young Patients With Femoral Head Osteonecrosis

The Journal of Arthroplasty ◽

10.1016/j.arth.2010.03.010 ◽

2011 ◽

Vol 26 (2) ◽

pp. 218-223 ◽

Cited By ~ 27

Author(s):

Young-Hoo Kim ◽

Yoowang Choi ◽

Jun-Shik Kim

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Total Hip ◽

Cementless Total Hip Arthroplasty ◽

Femoral Head Osteonecrosis

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Long-term outcome after anterolateral open reduction and Salter osteotomy for late presenting developmental dysplasia of the hip

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.180076 ◽

2018 ◽

Vol 12 (4) ◽

pp. 364-368 ◽

Cited By ~ 2

Author(s):

S. R. Y. W. Thomas

Keyword(s):

Femoral Head ◽

Open Reduction ◽

Skeletal Maturity ◽

Hip Dislocation ◽

Term Outcome ◽

Long Term Outcome ◽

Femoral Head Osteonecrosis ◽

Salter Osteotomy ◽

Innominate Osteotomy

IntroductionOnly a handful of studies report outcomes after open reduction for developmental hip dislocation beyond skeletal maturity. For successfully reduced hips it is the outcome into late adulthood on which the results of this intervention should be judged. These studies indicate clearly the importance of preservation of the acetabular growth centres during surgery. The acetabulum must also be addressed when insufficient growth remains reliably to remodel residual dysplasia even after stable, concentric reduction.SummaryComparing the longest-term outcome studies for open reduction to less invasive, but mainly historical, techniques of gradual traction reduction it is unsettling to note that the latter protocols are associated with the best results. Whereas open reduction and innominate osteotomy are practised as originally described by Salter, gradual traction reduction has largely been abandoned.ConclusionsThere are probably aspects of the more time-consuming methods of gradual reduction that do not violate the hip joint capsule that expose the femoral head to a lower risk of femoral head osteonecrosis leading to better long-term outcomes.

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Hip-preserving surgical treatment for atraumatic femoral head necrosis

Genij Ortopedii ◽

10.18019/1028-4427-2020-26-4-495-501 ◽

2020 ◽

Vol 26 (4) ◽

pp. 495-501

Author(s):

A.E. Murzich ◽

◽

O.A. Sokolovsky ◽

G.A. Uryev ◽

◽

...

Keyword(s):

Femoral Head ◽

Minimally Invasive ◽

Bone Grafting ◽

Young Patients ◽

Core Decompression ◽

Autologous Bone Marrow ◽

Femoral Head Necrosis ◽

Long Term Results ◽

Surgical Interventions ◽

Femoral Head Osteonecrosis

Introduction Hip-salvage treatment in femoral head necrosis has a great social and economic importance.The number of hip joint replacements in young patients has been increasing. Purpose To evaluate the results of hip-preserving surgical interventions in the treatment of patients with non-traumatic femoral head necrosis. Materials and methods The study included 42 cases treated by minimally invasive core decompression of the femoral head and bone grafting, 22 cases of decompression and introduction of autologous bone marrow and mesenchymal stem cells into the core of necrosis, and six cases of using a titanium locking mesh implant. Results The follow-up time after surgery was up to 5 years. The survival rate of hip-reserving operations using cell technology to stimulate osteoregeneration were noticeably better than using bone grafting only in disease stages I, IIA, IIB, IIC. For femoral head osteonecrosis in stage IIIA, a titanium locking femoral head implant has been developed. It promotes regeneration and performs a supporting function. Conclusion The analysis of long-term results of these minimally invasive technologies has proven their efficacy and safety along with a low rate of complications.

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Total hip replacement in femoral head osteonecrosis

Proceedings of the National Academy of Sciences of Belarus Medical series ◽

10.29235/1814-6023-2020-17-2-203-210 ◽

2020 ◽

Vol 17 (2) ◽

pp. 203-210

Author(s):

A. E. Murzich ◽

N. S. Serdiuchenko ◽

V. A. Rabtsevich

Keyword(s):

Femoral Head ◽

Hip Replacement ◽

Friction Pair ◽

Young Patients ◽

Clinical Results ◽

Surgical Approaches ◽

Total Hip ◽

Femoral Head Osteonecrosis ◽

Level Of Activity ◽

Revision Operations

The experience of hip replacement in young patients with osteonecrosis of the femoral head was analyzed in the article. The results of operations in the osteonecrosis group and osteoarthritis group in 3 years and 7 months after operations were compared. In 97.5 % of cases, cementless fixation implants with a ceramic on ceramic friction pair (45 %) and ceramic on polyethylene friction pair (45 %) were used. Surgical approaches by Moore, Hardinge and AMIS technique were applied. The clinical results of operations in the studied groups were similar, but the survival rate of endoprostheses in the osteonecrosis group was 91.5 %, and in the osteoarthritis group 97.2 %. In the osteonecrosis group an increased frequency of complications (dislocation of the endoprosthesis head, periprosthetic fracture, periprosthetic infection) and revision operations were observed. Our results show the influence of risk factors, concomitant diseases, the level of activity of young patients on the long-term total hip arthroplasty result.

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