Analysis of the results of treatment of patients with aseptic necrosis of the femoral head (ANFH) after minimally invasive decompression and hip arthroplasty

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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Therapeutic effect of minimally invasive decompression combined with impaction bone grafting on osteonecrosis of the femoral head

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-012-1141-6 ◽

2012 ◽

Vol 23 (8) ◽

pp. 913-919 ◽

Cited By ~ 13

Author(s):

Hong-Jun Zhang ◽

You-Wen Liu ◽

Zhi-Qian Du ◽

Huili Guo ◽

Ke-Jie Fan ◽

...

Keyword(s):

Femoral Head ◽

Minimally Invasive ◽

Therapeutic Effect ◽

Bone Grafting ◽

Impaction Bone Grafting ◽

Minimally Invasive Decompression

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Corrective Intertrochanteric Osteotomy of the Femur for Aseptic Necrosis of the Femoral Head after Bloodless Reduction of Congenital Dislocation in School-Age Children

RA Journal Of Applied Research ◽

10.47191/rajar/v7i10.15 ◽

2021 ◽

Vol 07 (10) ◽

Author(s):

Khojaakhmed Shaykhislamovich Alpysbaev ◽

Keyword(s):

Femoral Head ◽

Hip Joint ◽

Hip Dislocation ◽

School Age Children ◽

Congenital Dislocation ◽

School Age ◽

Greater Trochanter ◽

Congenital Hip Dislocation ◽

Aseptic Necrosis ◽

Results Of Treatment

The immediate results of treatment of 72 children aged 7 to 12 years with aseptic necrosis of the femoral head after bloodless reduction of congenital hip dislocation were analyzed. When treating patients, the following types of surgical treatment were used:extra-articular or open centering of the femoral head with intertrochanteric-torsion-varizing or devarizing and rotational osteotomy of the femur with bringing down the greater trochanter in the caudal direction. In all patients, pain and lameness disappeared, internal rotation of the lower extremities when walking, and the range of motion in the hip joint improved. Improved radiometric parameters characterizing the ratio of the acetabulum and the head of the femur and the angular values of the hip joint and proximal femur.

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COMBINED IMPACTION AUTOPLASTY OF THE FEMORAL HEAD IN THE TREATMENT OF PATIENTS WITH EARLY STAGES OF ASEPTIC NECROSIS

Science and Innovations in Medicine ◽

10.35693/2500-1388-2017-0-3-39-44 ◽

2017 ◽

Vol 2 (3) ◽

pp. 39-44

Author(s):

DS S Kudashev ◽

SD D Zuev-Ratnikov ◽

IS S Shorin

Keyword(s):

Femoral Head ◽

Pain Syndrome ◽

Pathological Process ◽

Diagnostic Methods ◽

New Method ◽

Harris Hip Score ◽

Aseptic Necrosis ◽

Early Stages ◽

Functional Capabilities ◽

Results Of Treatment

Aseptic necrosis of the femoral head refers to the number of severe, rapidly progressing destructive-dystrophic hip joint lesions. In the overwhelming majority of cases, the disease develops in young and most active age group. In the absence of necessary treatment, the result of the disease is the early disability retirement with the need for radical reconstructive interventions on the joint. The use of modern diagnostic methods makes it possible to detect the beginning of the pathological process in the femoral head in the early stages and to conduct the most effective treatment of patients of this category. Aim - to improve the results of treatment of patients with early stages of aseptic necrosis of the femoral head due to the development and introduction into clinical practice of a new method of combined impaction autoplasty of the femoral head. Materials and methods. A new method of combined impaction autoplasty of the femoral head was used, including decompression, intraosseous resection and excision of the focus of osteonecrosis followed by combined autoplasty of the postresection defect (RF patent No. 2583577 dated 13.04.2016). Intraosseous resection of the focus of destruction of the femoral head was performed with the help of a specially developed device - milling cutters for bone tissue resection (RF patent for utility model No. 171951 dated 21.06.2017). Evaluation of the effectiveness of the treatment was carried out on the basis of the severity of the pain syndrome and functional capabilities of patients defined by the Harris scale (Harris Hip Score). Results. The analysis of the medium-term results of the conducted treatment showed that good results were obtained in 67.4% of cases in which the proposed method was used.

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Results of Treatment for Aseptic Necrosis of the Femoral Head with Vascularized Bone Graft.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.40.962 ◽

1992 ◽

Vol 40 (3) ◽

pp. 962-964

Author(s):

Kosei Ijiri ◽

Nagatoshi Yoshikuni ◽

Hidefumi Kawaida ◽

Hiroshi Ito ◽

Mitsuhiro Yanase ◽

...

Keyword(s):

Femoral Head ◽

Bone Graft ◽

Vascularized Bone Graft ◽

Aseptic Necrosis ◽

Results Of Treatment ◽

Vascularized Bone

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Mid-term outcomes of arthroscopic-assisted Core decompression of Precollapse osteonecrosis of femoral head—minimum of 5 year follow-up

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2853-0 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Mark R. Nazal ◽

Ali Parsa ◽

Scott D. Martin

Keyword(s):

Femoral Head ◽

Minimally Invasive ◽

Cohort Analysis ◽

Case Series ◽

Stage I ◽

Labral Repair ◽

Preoperative Imaging ◽

Assisted Management ◽

Minimally Invasive Decompression

Abstract Background Osteonecrosis of the femoral head (ONFH) is a progressive disease that leads to collapse and the development of secondary arthritis. The preferred management of ONFH remains controversial. Arthroscopic-assisted management of ONFH is a new and evolving approach for hip preservation. We hypothesis that arthroscopy is able to improve ONFH outcomes by achieving accurate and minimally invasive decompression while successfully addressing concomitant intraarticular pathologies resulting in reliable mid-term outcomes. Methods This was a retrospective cohort analysis. All patients had atraumatic ONFH with a precollapse lesion and a minimum follow-up of 5 years. Results A total cohort of 11 hips (8 patients) was identified. The mean patient follow-up was 7 years ±1.48 years (range, 64—118 months). The Ficat-Alret classification found on preoperative imaging was Stage I—3 (27.2%), IIa—4 (36.4%), and IIb—4 (36.4%) hips. Four (36.4%) hips experienced mechanical issues, including locking, catching, and buckling. The most common concomitant pathology addressed at the time of arthroscopy, was labral repair/debridement—8 (73%), followed by microfracture—7 (64%). At final follow-up, 6 hips (54.5%) had not converted to THA. Upon further stratification, Stage I—100%, Stage IIa—75%, for a combined 87%, had not converted to THA, in contrast, 100% of hips categorized as Stage IIb had converted to THA. Ficat-Alret staging, especially Stage IIb, was significantly associated with conversion to THA. (p-value = 0.015) There were 0% major or minor complications. Conclusions To our knowledge, this is the longest reported follow-up of arthroscopic-assisted management of ONFH. Arthroscopic-assisted management is a promising surgical approach that provides safe, accurate, and minimally invasive decompression, resulting in reliable results with an acceptable conversion rate to THA. Level of evidence Level IV, Case Series.

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