Recent trends in Hip Joint Avascular Necrosis Salvage Procedures
Mustafa Abdul Khaliq Mohammed Hassan;
Abstract
Background: Osteonecrosis, in adults also known as aseptic necrosis, avascular necrosis (AVN), atraumatic necrosis, and ischemic necrosis, is a pathologic process that has been associated with numerous conditions and therapeutic interventions. In patients in whom there is direct damage to bone vasculature (e.g. femoral neck fracture) or direct injury of bone or marrow elements (e.g. radiation injury, dysbarism, or Caisson's disease), the cause is clearly identifiable. However, in many patients, the mechanisms by which this disorder develops are not fully understood.
Aims: Get a focus on recent trends in Joint-preserving procedures in avascular necrosis of the hip joint.
Methodology: Osteonecrosis is a pathologic process that has been associated with trauma, with numerous atraumatic conditions, and with therapeutic interventions, most commonly corticosteroid use and excessive alcohol intake. Compromise of the bone vasculature, leading to the death of bone and marrow cells (bone marrow infarction), and ultimate mechanical failure appear to be the common etiologies shared by the varied proposed causes. The mean age at diagnosis is less than 40 years.
Conclusion: Symptomatic hip osteonecrosis is a disabling condition with poorly understood etiology and pathogenesis. Numerous treatment options for hip osteonecrosis have been described including nonoperative modalities, joint preserving procedures, and THR. Nonoperative or joint preserving treatment may improve outcomes when an early diagnosis is made before the lesion has become too large, or there is radiographic evidence of femoral head collapse. The presence of a crescent sign, femoral head flattening, and acetabular involvement indicate a more advanced-stage disease in which joint preserving options are less effective than THR. The algorithm of ONFH management as presented is an effective treatment strategy which is practically feasible and based on sound evidence.
Keywords: Recent trends, Hip Joint, Avascular Necrosis, Salvage Procedures
Aims: Get a focus on recent trends in Joint-preserving procedures in avascular necrosis of the hip joint.
Methodology: Osteonecrosis is a pathologic process that has been associated with trauma, with numerous atraumatic conditions, and with therapeutic interventions, most commonly corticosteroid use and excessive alcohol intake. Compromise of the bone vasculature, leading to the death of bone and marrow cells (bone marrow infarction), and ultimate mechanical failure appear to be the common etiologies shared by the varied proposed causes. The mean age at diagnosis is less than 40 years.
Conclusion: Symptomatic hip osteonecrosis is a disabling condition with poorly understood etiology and pathogenesis. Numerous treatment options for hip osteonecrosis have been described including nonoperative modalities, joint preserving procedures, and THR. Nonoperative or joint preserving treatment may improve outcomes when an early diagnosis is made before the lesion has become too large, or there is radiographic evidence of femoral head collapse. The presence of a crescent sign, femoral head flattening, and acetabular involvement indicate a more advanced-stage disease in which joint preserving options are less effective than THR. The algorithm of ONFH management as presented is an effective treatment strategy which is practically feasible and based on sound evidence.
Keywords: Recent trends, Hip Joint, Avascular Necrosis, Salvage Procedures
Other data
| Title | Recent trends in Hip Joint Avascular Necrosis Salvage Procedures | Other Titles | الاتجاهات الحديثة في إجراءات الإنقاذ للنخر اللاوعائي لمفصل الفخذ | Authors | Mustafa Abdul Khaliq Mohammed Hassan | Issue Date | 2016 |
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