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The Pathology and Management of Osteonecrosis of the Hip

Chapter

Abstract

Osteonecrosis of the hip is a pathological condition characterised by a vascular insult to the femoral head and progressive collapse of the bone. This results in pain, secondary degenerative wear of the hip joint and loss of function. Most cases progress to collapse if left untreated, resulting in the need for total hip arthroplasty which has a successful outcome for the majority of patients.

Keywords

Systemic Lupus Erythematosus Femoral Head Core Decompression Ligamentum Teres Femoral Head Osteonecrosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Plancher KD, Razi A. Management of osteonecrosis of the femoral head. Orthop Clin North Am. 1997;28(3):461–77.PubMedCrossRefGoogle Scholar
  2. 2.
    Grose AW, Gardner MJ, Sussmann PS, Helfet DL, Lorich DG. The surgical anatomy of the blood supply to the femoral head: description of the anastomosis between the medial femoral circumflex and inferior gluteal arteries at the hip. J Bone Joint Surg Br. 2008;90(10):1298–303.PubMedGoogle Scholar
  3. 3.
    Lieberman JR, Berry DJ, Mont MA, et al. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect. 2003;52:337–55.PubMedGoogle Scholar
  4. 4.
    Pritchett JW. Statin therapy decreases the risk of osteonecrosis in patients receiving steroids. Clin Orthop Relat Res. 2001;386:173–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Keizer SB, Kock NB, Dijkstra PD, Taminiau AH, Nelissen RG. Treatment of avascular necrosis of the hip by a non-vascularised cortical graft. J Bone Joint Surg Br. 2006;88(4):460–6.PubMedGoogle Scholar
  6. 6.
    Matsuo K, Hirohata T, Sugioka Y, Ikeda M, Fukuda A. Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res. 1988;234:115–23.PubMedGoogle Scholar
  7. 7.
    Ries MD, Barcohana B, Davidson A, Jergesen HE, Paiement GD. Association between human immunodeficiency virus and osteonecrosis of the femoral head. J Arthroplasty. 2002;17(2):135–9.PubMedCrossRefGoogle Scholar
  8. 8.
    McCarthy I. The physiology of bone blood flow: a review. J Bone Joint Surg Am. 2006;88 Suppl 3:4–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Liu YF, Chen WM, Lin YF, et al. Type II collagen gene variants and inherited osteonecrosis of the femoral head. N Engl J Med. 2005;352(22):2294–301.PubMedCrossRefGoogle Scholar
  10. 10.
    Vail TP, Covington DB. In: Urbaniak JR, Jones JR, editors. Osteonecrosis: etiology, diagnosis, treatment. Rosemont: American Academy of Orthopedic Surgeons; 1997. p. 43–9.Google Scholar
  11. 11.
    Ruch DS, Sekiya J, Dickson Schaefer W, Koman LA, Pope TL, Poehling GG. The role of hip arthroscopy in the evaluation of avascular necrosis. Orthopedics. 2001;24(4):339–43.PubMedGoogle Scholar
  12. 12.
    Arlet J, Ficat P. Non-traumatic avascular femur head necrosis. New methods of examination and new concepts. Chir Narzadow Ruchu Ortop Pol. 1977;42(3):269–76.PubMedGoogle Scholar
  13. 13.
    Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br. 1995;77(1):34–41.PubMedGoogle Scholar
  14. 14.
    Mont MA, Zywiel MG, Marker DR, McGrath MS, Delanois RE. The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg Am. 2010;92(12):2165–70.PubMedCrossRefGoogle Scholar
  15. 15.
    D’Aubigne RM, Postel M, Mazabraud A, Massias P, Gueguen J, France P. Idiopathic necrosis of the femoral head in adults. J Bone Joint Surg Br. 1965;47(4):612–33.Google Scholar
  16. 16.
    Mont MA, Hungerford DS. Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am. 1995;77(3):459–74.PubMedGoogle Scholar
  17. 17.
    Aaron RK, Lennox D, Bunce GE, Ebert T. The conservative treatment of osteonecrosis of the femoral head. A comparison of core decompression and pulsing electromagnetic fields. Clin Orthop Relat Res. 1989;249:209–18.PubMedGoogle Scholar
  18. 18.
    Stulberg BN, Davis AW, Bauer TW, Levine M, Easley K. Osteonecrosis of the femoral head. A prospective randomized treatment protocol. Clin Orthop Relat Res. 1991;268:140–51.PubMedGoogle Scholar
  19. 19.
    Koo KH, Kim R, Ko GH, Song HR, Jeong ST, Cho SH. Preventing collapse in early osteonecrosis of the femoral head. A randomised clinical trial of core decompression. J Bone Joint Surg Br. 1995;77(6):870–4.PubMedGoogle Scholar
  20. 20.
    Smith SW, Fehring TK, Griffin WL, Beaver WB. Core decompression of the osteonecrotic femoral head. J Bone Joint Surg Am. 1995;77(5):674–80.PubMedGoogle Scholar
  21. 21.
    Bozic KJ, Zurakowski D, Thornhill TS. Survivorship analysis of hips treated with core decompression for nontraumatic osteonecrosis of the femoral head. J Bone Joint Surg Am. 1999;81(2):200–9.PubMedGoogle Scholar
  22. 22.
    Steinberg ME. Core decompression. Semin Arthroplasty. 1998;9:213–20.Google Scholar
  23. 23.
    Hungerford DS, Jones LC. Asymptomatic osteonecrosis: should it be treated? Clin Orthop Relat Res. 2004;429:124–30.PubMedCrossRefGoogle Scholar
  24. 24.
    Urbaniak JR, Coogan PG, Gunneson EB, Nunley JA. Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting. A long-term follow-up study of one hundred and three hips. J Bone Joint Surg Am. 1995;77(5):681–94.PubMedGoogle Scholar
  25. 25.
    Kane SM, Ward WA, Jordan LC, Guilford WB, Hanley Jr EN. Vascularized fibular grafting compared with core decompression in the treatment of femoral head osteonecrosis. Orthopedics. 1996;19(10):869–72.PubMedGoogle Scholar
  26. 26.
    Yoo MC, Kim KI, Hahn CS, Parvizi J. Long-term followup of vascularized fibular grafting for femoral head necrosis. Clin Orthop Relat Res. 2008;466(5):1133–40.PubMedCrossRefGoogle Scholar
  27. 27.
    Vail TP, Urbaniak JR. Donor-site morbidity with use of vascularized autogenous fibular grafts. J Bone Joint Surg Am. 1996;78(2):204–11.PubMedGoogle Scholar
  28. 28.
    Boettcher WG, Bonfiglio M, Hamilton HH, Sheets RF, Smith K. Non-traumatic necrosis of the femoral head. I. Relation of altered hemostasis to etiology. J Bone Joint Surg Am. 1970;52(2):312–21.PubMedGoogle Scholar
  29. 29.
    Dunn AW, Grow T. Aseptic necrosis of the femoral head. Treatment with bone grafts of doubtful value. Clin Orthop Relat Res. 1977;122:249–54.PubMedGoogle Scholar
  30. 30.
    Rosenwasser MP, Garino JP, Kiernan HA, Michelsen CB. Long term followup of thorough debridement and cancellous bone grafting of the femoral head for avascular necrosis. Clin Orthop Relat Res. 1994;306:17–27.PubMedGoogle Scholar
  31. 31.
    Meyers MH, Convery FR. Grafting procedures in osteonecrosis of the hip. Semin Arthroplasty. 1991;2:189–97.Google Scholar
  32. 32.
    Mont MA, Etienne G, Ragland PS. Outcome of nonvascularized bone grafting for osteonecrosis of the femoral head. Clin Orthop Relat Res. 2003;417:84–92.PubMedGoogle Scholar
  33. 33.
    Sugioka Y, Hotokebuchi T, Tsutsui H. Transtrochanteric anterior rotational osteotomy for idiopathic and steroid-induced necrosis of the femoral head. Indications and long-term results. Clin Orthop Relat Res. 1992;277:111–20.PubMedGoogle Scholar
  34. 34.
    Mont MA, Fairbank AC, Krackow KA, Hungerford DS. Corrective osteotomy for osteonecrosis of the femoral head. J Bone Joint Surg Am. 1996;78(7):1032–8.PubMedGoogle Scholar
  35. 35.
    Callaghan JJ, Brand RA, Pedersen DR. Hip arthrodesis. A long-term follow-up. J Bone Joint Surg Am. 1985;67(9):1328–35.PubMedGoogle Scholar
  36. 36.
    Lee SB, Sugano N, Nakata K, Matsui M, Ohzono K. Comparison between bipolar hemiarthroplasty and THA for osteonecrosis of the femoral head. Clin Orthop Relat Res. 2004;424:161–5.PubMedCrossRefGoogle Scholar
  37. 37.
    Ito H, Matsuno T, Kaneda K. Bipolar hemiarthroplasty for osteonecrosis of the femoral head. A 7- to 18-year followup. Clin Orthop Relat Res. 2000;374:201–11.PubMedCrossRefGoogle Scholar
  38. 38.
    Pellegrini Jr VD, Heiges BA, Bixler B, Lehman EB, Davis 3rd CM. Minimum ten-year results of primary bipolar hip arthroplasty for degenerative arthritis of the hip. J Bone Joint Surg Am. 2006;88(8):1817–25.PubMedCrossRefGoogle Scholar
  39. 39.
    Saito S, Saito M, Nishina T, Ohzono K, Ono K. Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis. Clin Orthop Relat Res. 1989;244:198–207.PubMedGoogle Scholar
  40. 40.
    Brinker MR, Rosenberg AG, Kull L, Galante JO. Primary total hip arthroplasty using noncemented porous-coated femoral components in patients with osteonecrosis of the femoral head. J Arthroplasty. 1994;9(5):457–68.PubMedCrossRefGoogle Scholar
  41. 41.
    Johannson HR, Zywiel MG, Marker DR, Jones LC, McGrath MS, Mont MA. Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Int Orthop. 2011;35(4):465–73.PubMedCrossRefGoogle Scholar
  42. 42.
    Kirschenbaum IH, Vernace JV, Booth Jr RE, Balderston RA, Rothman RH. Total hip arthroplasty for osteonecrosis. Semin Arthroplasty. 1991;2(3):234–40.PubMedGoogle Scholar
  43. 43.
    Fyda TM, Callaghan JJ, Olejniczak J, Johnston RC. Minimum ten-year follow-up of cemented total hip replacement in patients with osteonecrosis of the femoral head. Iowa Orthop J. 2002;22:8–19.PubMedGoogle Scholar
  44. 44.
    Kantor SG, Huo MH, Huk OL, Salvati EA. Cemented total hip arthroplasty in patients with osteonecrosis. A 6-year minimum follow-up study of second-generation cement techniques. J Arthroplasty. 1996;11(3):267–71.PubMedCrossRefGoogle Scholar
  45. 45.
    Kim YH, Oh SH, Kim JS, Koo KH. Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head. J Bone Joint Surg Am. 2003;85-A(4):675–81.PubMedGoogle Scholar
  46. 46.
    Piston RW, Engh CA, De Carvalho PI, Suthers K. Osteonecrosis of the femoral head treated with total hip arthroplasty without cement. J Bone Joint Surg Am. 1994;76(2):202–14.PubMedGoogle Scholar
  47. 47.
    Kim YH, Choi Y, Kim JS. Cementless total hip arthroplasty with alumina-on-highly cross-linked polyethylene bearing in young patients with femoral head osteonecrosis. J Arthroplasty. 2011;26(2):218–23.PubMedCrossRefGoogle Scholar
  48. 48.
    Katz RL, Bourne RB, Rorabeck CH, McGee H. Total hip arthroplasty in patients with avascular necrosis of the hip. Follow-up observations on cementless and cemented operations. Clin Orthop Relat Res. 1992;281:145–51.PubMedGoogle Scholar
  49. 49.
    Lins RE, Barnes BC, Callaghan JJ, Mair SD, McCollum DE. Evaluation of uncemented total hip arthroplasty in patients with avascular necrosis of the femoral head. Clin Orthop Relat Res. 1993;297:168–73.PubMedGoogle Scholar
  50. 50.
    Levitsky J, Te HS, Cohen SM. The safety and outcome of joint replacement surgery in liver transplant recipients. Liver Transpl. 2003;9(4):373–6.PubMedCrossRefGoogle Scholar
  51. 51.
    Bose VC, Baruah BD. Resurfacing arthroplasty of the hip for avascular necrosis of the femoral head: a minimum follow-up of four years. J Bone Joint Surg Br. 2010;92(7):922–8.PubMedGoogle Scholar
  52. 52.
    Amstutz HC, Le Duff MJ. Hip resurfacing results for osteonecrosis are as good as for other etiologies at 2 to 12 years. Clin Orthop Relat Res. 2010;468(2):375–81.PubMedCrossRefGoogle Scholar
  53. 53.
    Grammatopolous G, Pandit H, Kwon YM, et al. Hip resurfacings revised for inflammatory pseudotumour have a poor outcome. J Bone Joint Surg Br. 2009;91(8):1019–24.PubMedGoogle Scholar
  54. 54.
    Haddad FS, Thakrar RR, Hart AJ, et al. Metal-on-metal bearings: the evidence so far. J Bone Joint Surg Br. 2011;93(5):572–9.PubMedGoogle Scholar
  55. 55.
    Glueck CJ, Freiberg RA, Sieve L, Wang P. Enoxaparin prevents progression of stages I and II osteonecrosis of the hip. Clin Orthop Relat Res. 2005;435:164–70.PubMedCrossRefGoogle Scholar
  56. 56.
    Agarwala S, Shah S, Joshi VR. The use of alendronate in the treatment of avascular necrosis of the femoral head: follow-up to eight years. J Bone Joint Surg Br. 2009;91(8):1013–8.PubMedGoogle Scholar
  57. 57.
    Li ZH, Liao W, Cui XL, et al. Intravenous transplantation of allogeneic bone marrow mesenchymal stem cells and its directional migration to the necrotic femoral head. Int J Med Sci. 2011;8(1):74–83.PubMedCrossRefGoogle Scholar
  58. 58.
    Steinberg ME, Brighton CT, Corces A. Osteonecrosis of the femoral head; results of core depression and grafting with electrical stimulation. Clin Orthop. 1989;249:199–208.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.The Rothman InstitutePhiladelphiaUSA

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