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Current Procedures and Techniques for the Treatment of Osteonecrosis of the Hip

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Hip Joint Restoration

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Abstract

Osteonecrosis of the hip is a devastating condition that typically affects younger patients. Overall osteonecrosis is a result of blood flow impediment to the femoral head; however, the exact etiology is currently unknown. Diagnosis is usually through plain AP and frog lateral radiographs in late stage disease, while in early stage disease MRI is the gold standard. Furthermore, early diagnosis is key in these patients, as once the femoral head presents with collapse, total hip arthroplasty is the standard of care. However, if caught early several joint-preserving procedures may be attempted depending on the stage of disease. Joint-preserving procedures, such as core decompression either with a core tract or multiple drilling techniques, and nonvascularized and vascularized bone grafting, have demonstrated excellent outcomes in several long-term studies. Additionally, studies of total hip arthroplasty once the femoral head has collapsed have demonstrated excellent outcomes at long term as well. Given the results of recent studies, we have improved our outcomes of operative procedure in these patients. Despite these positive outcomes, it is imperative that the operating surgeon counsel patients about the possibility for a need for further procedures.

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Authors and Affiliations

  1. Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2041 West Belvedere Avenue, Baltimore, MD, 21215, USA

    Samik Banerjee MD, Bhaveen H. Kapadia MD, Jeffrey J. Cherian DO & Michael A. Mont MD

  2. Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, NY, USA

    Bhaveen H. Kapadia MD

Authors
  1. Samik Banerjee MD
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  2. Bhaveen H. Kapadia MD
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  3. Jeffrey J. Cherian DO
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  4. Michael A. Mont MD
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Corresponding author

Correspondence to Michael A. Mont MD .

Editor information

Editors and Affiliations

  1. Orthopedic Surgery, Hip Joint Arthroplasty, Hip Arthroscopy Massachusetts General Hospital, Boston, Massachusetts, USA

    Joseph C. McCarthy

  2. Institute of Orthopedic Research and Education, Houston, Texas, USA

    Philip C. Noble

  3. Consultant Orthopedic Surgeon Orthopedics, The Villar Bajwa Practice, Spire Cambridge Lea Hospital, Cambridge, United Kingdom

    Richard N. Villar

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Banerjee, S., Kapadia, B.H., Cherian, J.J., Mont, M.A. (2017). Current Procedures and Techniques for the Treatment of Osteonecrosis of the Hip. In: McCarthy, J., Noble, P., Villar, R. (eds) Hip Joint Restoration. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0694-5_60

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  • DOI: https://doi.org/10.1007/978-1-4614-0694-5_60

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  • Online ISBN: 978-1-4614-0694-5

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