Osteonecrosis of the Femoral Head.

Abstract

Osteonecrosis of the femoral head most commonly arises from trauma or corticosteroid and alcohol use but is also associated with blood dyscrasias and metabolic and coagulation disorders. Initial evaluation includes a history and physical examination and plain radiographs. Early-stage osteonecrosis is best evaluated by MRI. The Ficat and Arlet classification system is the most widely used. Nonoperative treatment has been studied using bisphosphonates, anticoagulants, vasodilators, statins, and biophysical modalities. Operative treatment includes core decompression with or without adjuvants, such as autologous bone marrow, whereas total hip arthroplasty is reserved for advanced-stage osteonecrosis in older patients or those who have failed joint-preserving treatment.

• Authors: Anna Cohen-Rosenblum, Quanjun Cui
• Journal: The Orthopedic clinics of North America (Orthop Clin North Am) Vol. 50 Issue 2 Pg. 139-149 (Apr 2019) ISSN: 1558-1373 [Electronic] United States
• PMID: 30850073 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Adrenal Cortex Hormones

Topics

• Adrenal Cortex Hormones (adverse effects)
• Arthroplasty, Replacement, Hip (methods)
• Bone Marrow Transplantation (methods)
• Decompression, Surgical (methods)
• Femur Head (diagnostic imaging, pathology)
• Femur Head Necrosis (diagnostic imaging, drug therapy, etiology, surgery)
• Humans
• Magnetic Resonance Imaging (methods)
• Male
• Meta-Analysis as Topic
• Middle Aged
• Paraproteinemias (complications)
• Radiography (methods)
• Risk Factors
• Treatment Outcome