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The Adult Hip - Master Case Series and Techniques pp 303–326Cite as

Osteonecrosis

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Abstract

Osteonecrosis of the femoral head (ONFH) is a multifactorial debilitating condition that may lead to progressive destruction of the hip joint. The incidence of the disease increases among the third and fifth decade of life [1]. ONFH is the diagnosis of 5–12% of annually performed THAs in the USA [1, 2]. The pathogenesis of the disease has not been fully delineated; it is probably a multifactorial process where the genetic predisposition plays a crucial role [3, 4]. The main risk factors that have been associated with the pathogenetic mechanism of ONFH are the trauma as hip fracture and dislocation, corticosteroids or excessive alcohol consumption, coagulation disorders and haemoglobinopathies [4]. Fat and air embolization, autoimmune and storage diseases, smoking and hyperlipidaemia have also been implicated [1, 5].

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References

  1. Zalavras CG, Lieberman JR. Osteonecrosis of the femoral head: evaluation and treatment. J Am Acad Orthop Surg. 2014;22(7):455–64.

    Article  PubMed  Google Scholar 

  2. Moya-Angeler J, Gianakos AL, Villa JC, Ni A, Lane JM. Current concepts on osteonecrosis of the femoral head. World J Orthop. 2015;6(8):590–601.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Zalavras CG, Vartholomatos G, Dokou E, Malizos KN. Genetic background of osteonecrosis: associated with thrombophilic mutations? Clin Orthop Relat Res. 2004;422:251–5.

    Article  Google Scholar 

  4. Scaglione M, Fabbri L, Celli F, Casella F, Guido G. Hip replacement in femoral head osteonecrosis: current concepts. Clin Cases Miner Bone Metabol. 2015;12(Suppl. 1):51–4. Supplement to n.3 2015

    Google Scholar 

  5. Lieberman JR, Roth KM, Elsissy P, Dorey FJ, Kobashigawa JA. Symptomatic osteonecrosis of the hip and knee after cardiac transplantation. J Arthroplast. 2008;23(1):90–6.

    Article  Google Scholar 

  6. Issa K, Pivec R, Kapadia BH, Banerjee S, Mont MA. Osteonecrosis of the femoral head: the total hip replacement solution. Bone Joint J. 2013;95-B(11 Suppl A):46–50.

    Article  CAS  PubMed  Google Scholar 

  7. Mont MA, Marulanda GA, Jones LC, Saleh KJ, Gordon N, Hungerfor DS, et al. Systematic analysis of classification systems for osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88(Suppl 3):16–26.

    PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  Google Scholar 

  10. Chen CH, Chang JK, Lai KA, Hou SM, Chang CH, Wang GJ. Alendronate in the prevention of collapse of the femoral head in nontraumatic osteonecrosis: a two-year multicenter, prospective, randomized, double-blind, placebo-controlled study. Arthritis Rheum. 2012;64(5):1572–8.

    Article  CAS  PubMed  Google Scholar 

  11. Wang CJ, Wang FS, Huang CC, Yang KD, Weng LH, Huang HY. Treatment for osteonecrosis of the femoral head: comparison of extracorporeal shock waves with core decompression and bone grafting. J Bone Joint Surg Am. 2005;87(11):2380–7.

    PubMed  Google Scholar 

  12. Gangji V, De Maertelaer V, Hauzeur JP. Autologous bone marrow cell implantation in the treatment of non-traumatic osteonecrosis of the femoral head: five year follow-up of a prospective controlled study. Bone. 2011;49(5):1005–9.

    Article  PubMed  Google Scholar 

  13. Eward WC, Rineer CA, Urbaniak JR, Richard MJ, Ruch DS. The vascularized fibular graft in precollapse osteonecrosis: is long-term hip preservation possible? Clin Orthop Relat Res. 2012;470(10):2819–26.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ortiguera CJ, Pulliam IT, Cabanela ME. Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up. J Arthroplast. 1999;14(1):21–8.

    Article  CAS  Google Scholar 

  15. Lavernia CJ, Villa JM. Total hip arthroplasty in the treatment of osteonecrosis of the femoral head: then and now. Curr Rev Musculoskelet Med. 2015;8(3):260–4.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. Cornell CN, Salvati EA, Pellicci PM. Long-term follow-up of total hip replacement in patients with osteonecrosis. Orthop Clin North Am. 1985;16:757–69.

    PubMed  CAS  Google Scholar 

  18. Stauffer RN. Ten-year follow-up study of total hip replacement. J Bone Joint Surg Am. 1982;64-A:983–90.

    Article  Google Scholar 

  19. Chandler HP, Reineck FT, Wixson RL, McCarthy JC. Total hip replacement in patients younger than thirty years old: a five-year follow-up study. J Bone Joint Surg Am. 1981;63-A:1426–34.

    Article  Google Scholar 

  20. Issa K, Naziri Q, Rasquinha VJ, et al. Outcomes of primary total hip arthroplasty in systemic lupus erythematosus with a proximally-coated cementless stem. J Arthroplasty. 2013;28(9):1663–6.

    Article  PubMed  Google Scholar 

  21. Baek SH, Kim SY. Cementless total hip arthroplasty with alumina bearings in patients younger than fifty with femoral head osteonecrosis. J Bone Joint Surg Am. 2008;90-A:1314–20.

    Article  Google Scholar 

  22. Issa K, Johnson AJ, Naziri Q, et al. Hip osteonecrosis: does prior hip surgery alter outcomes compared to an initial primary total hip arthroplasty? J Arthroplasty. 2014;29(1):162–6.

    Article  PubMed  Google Scholar 

  23. Mont MA, Seyler TM, Plate JF, Delanois RE, Parvizi J. Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am. 2006;88-A(Suppl):104–9.

    Google Scholar 

  24. Seyler TM, Bonutti PM, Shen J, Naughton M, Kester M. Use of an alumina-on alumina bearing system in total hip arthroplasty for osteonecrosis of the hip. J Bone Joint Surg Am. 2006;88-A(Suppl):116–25.

    Google Scholar 

  25. Wang TI, Hung SH, Su YP, et al. Noncemented total hip arthroplasty for osteonecrosis of the femoral head in elderly patients. Orthopedics. 2013;36:271–5.

    Article  Google Scholar 

  26. Issa K, Naziri Q, Maheshwari AV, et al. Excellent results and minimal complications of total hip arthroplasty in sickle cell hemoglobinopathy at mid-term follow-up using cementless prosthetic components. J Arthroplasty. 2013;28(9):1693–8.

    Article  PubMed  Google Scholar 

  27. Ilyas I, Moreau P. Simultaneous bilateral total hip arthroplasty in sickle cell disease. J Arthroplast. 2002;17:441–5.

    Article  CAS  Google Scholar 

  28. Marulanda GA, Minniti CP, Ulrich SD, Seyler TM, Mont MA. Perioperative management for orthopaedic patients with sickle cell anaemia. J Orthop Surg. 2009;17:346–50.

    Article  Google Scholar 

  29. Chang JS, Han DJ, Park SK, Sung JH, Ha YC. Cementless total hip arthroplasty in patients with osteonecrosis after kidney transplantation. J Arthroplast. 2013;28:824–7.

    Article  Google Scholar 

  30. Min BW, Lee KJ, Song KS, Bae KC, Cho CH. Highly cross-linked polyethylene in total hip arthroplasty for osteonecrosis of the femoral head: a minimum 5-year follow-up study. J Arthroplast. 2013;28:526–30.

    Article  Google Scholar 

  31. 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 Arthroplast. 2011;26:218–23.

    Article  CAS  Google Scholar 

  32. Kim YH, Kim JS, Park JW, Joo JH. Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head: a concise followup, at an average of seventeen years, of a previous report. J Bone Joint Surg [Am]. 2011;93-A:1806–10.

    Article  Google Scholar 

  33. Kawasaki M, Hasegawa Y, Sakano S, Masui T, Ishiguro N. Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Arthroplast. 2005;20:574–9.

    Article  Google Scholar 

  34. Ball ST, Le Duff MJ, Amstutz HC. Early results of conversion of a failed femoral component in hip resurfacing arthroplasty. J Bone Joint Surg Am. 2007;89-A:735–41.

    Google Scholar 

  35. Helbig L, Simank HG, Kroeber M, et al. Core decompression combined with implantation of a demineralised bone matrix for non-traumatic osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2012;132:1095–110.

    Article  CAS  PubMed  Google Scholar 

  36. Bedard NA, Callaghan JJ, Liu SS, Greiner JJ, Klaassen AL, Johnston RC. Cementless THA for the treatment of osteonecrosis at 10-year follow-up: have we improved compared to cemented THA? J Arthroplast. 2013;28(7):1192–1199. Epub 2013 Feb 12. doi:10.1016/j.arth.2012.09.008.

    Article  Google Scholar 

  37. Yu L, Qi C, Yu T, Meng Q, Zhao X, Liu K, Cai Y. A comparative study on short-termeffectiveness between cemented and uncementedtotal hip arthroplasty for osteonecrosis of femoral headafterrenal transplantation. ZhongguoXiu Fu Chong JianWaiKeZaZhi. 2013 Dec;27(12):1409–13.

    Google Scholar 

  38. Quesada MJ, Marker DR, Mont MA. Metal-on-metal hip resurfacing: advantages and disadvantages. J Arthroplast. 2008;23(7 suppl):69–73.

    Article  Google Scholar 

  39. Nunley RM, Della Valle CJ, Barrack RL. Is patient selection important for hip resurfacing? Clin Orthop Relat Res. 2009;467(1):56–65.

    Article  PubMed  Google Scholar 

  40. Maus U, Roth A, Tingart M, Rader C, Jager M, Noth U, Reppenhagen S, Heiss C, Beckmann J. S3 guideline. Part 3: non-traumatic avascular necrosis in adults - surgical treatment of Atraumatic avascular femoral head necrosis in adults. Z Orthop Unfall. 2015;153(5):498–507.

    Article  CAS  PubMed  Google Scholar 

  41. Seung-Ju K, Dong-Geun K, Sung Bae P, Jong Hun K. Is hemiresurfacing arthroplasty for osteonecrosis of the hip a viable solution? J Arthroplast. 2015;30:987–92.

    Article  Google Scholar 

  42. Floerkemeier T, Budde S, Gronewold J, Radtke K, Ettinger M, Windhagen H, von Lewinski G. Short-stem hip arthroplasty in osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2015;135:715–22.

    Article  PubMed  Google Scholar 

  43. Zeh A, Weise A, Vasarhelyi A, Bach AG, Wohlrab D. Medium-term results of the Mayo short-stem hip prosthesis after avascular necrosis of the femoral head. Z Orthop Unfall. 2011;149(2):200.

    Article  CAS  PubMed  Google Scholar 

  44. Floerkemeier T, Tscheuschner N, Calliess T, Ezechieli M, Floerkemeier S, Budde S, Windhagen H, von Lewinski G. Cementless short stem hip arthroplasty METHA as an encouraging option in adults with osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2012;132(8):1125.

    Article  PubMed  Google Scholar 

  45. Fink B, Ruther W. Partial and total joint replacement in femur head necrosis. Orthopade. 2000;29(5):449.

    PubMed  CAS  Google Scholar 

  46. Karatosun V, Gunal I, Unver B, Gultekin A. Thrust plate prosthesis for osteonecrosis of the femoral head: short-term results of 15 patients followed 2–6 years. J Orthop Sci. 2006;11(5):450.

    Article  PubMed  Google Scholar 

  47. Mont MA, Cherian JJ, Sierra RJ, Jones LC, Lieberman JR. Nontraumatic osteonecrosis of the femoral head: where do we stand today? A ten-year update. J Bone Joint Surg Am. 2015;97(19):1604–27.

    Article  PubMed  Google Scholar 

  48. Takao M, et al. Cementless modular total hip arthroplasty with subtrochanteric shortening osteotomy for hips with developmental dysplasia. J Bone Joint Surg Am. 2011;93:548–55.

    Article  PubMed  Google Scholar 

  49. Liebermann JR, Berry DJ. Advanced reconstruction hip. Hip Society, AAOS 2006, chapter 16, pp. 115–20.

    Google Scholar 

  50. Goel SC. Management of sequelae of septic arthritis of hip in infancy, JK-practitioner. Rev Article. 2003;10(3):169–75.

    Google Scholar 

  51. Haentjens P, Lamraski G. Endoprosthetic replacement of unstable, comminuted intertrochanteric fracture of the femur in the elderly, osteoporotic patient: a review. Disabil Rehabil. 2005;27:1167–80.

    Article  CAS  PubMed  Google Scholar 

  52. Liu X-Z, Yang W, Yang S-H, Xu W-H, Ye S-N. Total hip arthroplasty for treatment of elderly patients with comminuted intertrochanteric fracture accompanied by femoral head necrosis. Chinese J Traumatol (English Ed). 2008;11:359–63.

    Article  Google Scholar 

  53. Weiss RJ, Kärrholm J, Hailer NP, Beckman MO, Stark A. Salvage of failed trochanteric and subtrochanteric fractures using a distally fixed, modular, uncemented hip revision stem. Acta Orthop. 2012;83:488–92.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Dean BJF, Matthews JJ, Price A, Stubbs D, Whitwell D, Gibbons CMLH. Modular endoprosthetic replacement for failed internal fixation of the proximal femur following trauma. Int Orthopaed (SICOT). 2011;36:731–4.

    Article  Google Scholar 

  55. Pui CM, Bostrom MP, Westrich GH, Valle CJD, Macaulay W, Mont MA, Padgett DE. Increased complication rate following conversion total hip arthroplasty after cephalomedullary fixation for intertrochanteric hip fractures: a multi-center study. J Arthroplasty. 2013;28:45–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Academic Orthopaedic Unit, Aristotle University Medical School, Thessaloniki, Greece

    Eustathios Kenanidis M.D., Ph.D., M.Sc. & Anastasios Nektarios Tzavellas M.D., M.Sc.

  2. Reading Shoulder Unit, Reading, UK

    Andreas Leonidou P.G.Dip., M.Sc., F.R.C.S.

  3. Academic Orthopaedic Unit, Papageorgiou General Hospital, Aristotle University Medical School, Thessaloniki, Greece

    Eleftherios Tsiridis M.D., Ph.D., F.A.C.S., F.R.C.S.

  4. Department of Surgical & Perioperative Sciences, Umeå University, Umeå, Sweden

    Arkan S. Sayed-Noor M.D., Ph.D., F.R.C.S. & Bakir Kadum M.D., Ph.D.

  5. ZNA Middelheim, Antwerp, Belgium

    Karl Brabants M.D. & Peter Mertens M.D.

  6. Pius Branzeu Emergency Clinical County Hospital, Timisoara, Romania

    Bogdan Nikolae Deleanu M.D., Ph.D.

  7. Victor Babes University of Medicine and Pharmacy, Timisoara, Romania

    Bogdan Nikolae Deleanu M.D., Ph.D.

Authors
  1. Eustathios Kenanidis M.D., Ph.D., M.Sc.
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  2. Anastasios Nektarios Tzavellas M.D., M.Sc.
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  3. Andreas Leonidou P.G.Dip., M.Sc., F.R.C.S.
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  4. Eleftherios Tsiridis M.D., Ph.D., F.A.C.S., F.R.C.S.
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  5. Arkan S. Sayed-Noor M.D., Ph.D., F.R.C.S.
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Corresponding authors

Correspondence to Arkan S. Sayed-Noor M.D., Ph.D., F.R.C.S. , Karl Brabants MD or Bogdan Nikolae Deleanu MD, PhD .

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  1. Aristotle University Medical School, Thessaloniki, Greece

    Eleftherios Tsiridis

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Kenanidis, E. et al. (2018). Osteonecrosis. In: Tsiridis, E. (eds) The Adult Hip - Master Case Series and Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-64177-5_10

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  • DOI: https://doi.org/10.1007/978-3-319-64177-5_10

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