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Osteonecrosis of the Femoral Head

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Osteonecrosis of the Femoral Head

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Abstract

Management of osteonecrosis of the femoral head is dependent on the stage of the disease and if there is collapse of the femoral head. Nonoperative management is rarely indicated, whereas core decompression with grafting can be a successful treatment method if used prior to collapse of the femoral head. For cases where subchondral collapse has occurred, total hip arthroplasty (THA) is the treatment of choice.

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References

  1. Muschler G, Boehm C, Easley K. Aspiration to obtain osteoblast progenitor cells from human bone marrow: the influence of aspiration volume. J Bone Joint Surg Am. 1997;79(11):1699–709.

    Article  CAS  PubMed  Google Scholar 

  2. Zalavras C, Lieberman JR. Osteonecrosis of the femoral head: evaluation and treatment. J Am Acad Orthop Surg. 2014;22:455–64.

    Article  PubMed  Google Scholar 

  3. Zalavras C, Dailiana Z, Elisaf M, et al. Potential aetiological factors concerning the development of osteonecrosis of the femoral head. Eur J Clin Invest. 2000;30(3):215–21.

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  5. 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. Arthritis Rheum. 2012;64(5):1572–8.

    Article  CAS  PubMed  Google Scholar 

  6. Lai KA, Shen WJ, Yang CY, Shao CJ, Hsu JT, Lin RM. The use of alendronate to prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis. J Bone Joint Surg Am. 2005;87-A(10):2155–9.

    Google Scholar 

  7. Lee YK, Ha YC, Cho YJ. Does zoledronate prevent femoral head collapse from osteonecrosis? A prospective, randomized, open-label, multicenter study. J Bone Joint Surg Am. 2015;97(14):1142–8.

    Article  PubMed  Google Scholar 

  8. Glueck C, Freiberg R, Sieve I, 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 

  9. Marker DR, Seyler TM, Ulrich SD, Srivastava S, Mont MA. Do modern techniques improve core decompression outcomes for hip osteonecrosis? Clin Orthop Relat Res. 2008;446(5):1093–103.

    Article  Google Scholar 

  10. Israelite C, Nelson CL, Ziarani CF, Abboud JA, Landa J, Steinberg ME. Bilateral core decompression for osteonecrosis of the femoral head. Clin Orthop Relat Res. 2005;441:285–90.

    Article  PubMed  Google Scholar 

  11. Lieberman JR, Conduah A, Urist MR. Treatment of osteonecrosis of the femoral head with core decompression and human bone morphogenetic protein. Clin Orthop Relat Res. 2004;429:139–45.

    Article  Google Scholar 

  12. Hernigou P, Beaujean F. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop Relat Res. 2002;405:14–23.

    Article  Google Scholar 

  13. Lieberman JR, Engstrom S, Meneghini R, SooHoo N. Which factors influence preservation of the osteonecrotic femoral head? Clin Orthop Relat Res. 2012;470:5235–535.

    Google Scholar 

  14. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Edward 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  Google Scholar 

  16. Plakseychuk AY, Kim SY, Park BC, Varitimidis SE, Rubash HE, Sotereanos DG. Vascularized compared with nonvascularized fibular grafting for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am. 2003;85(4):589–96.

    Article  PubMed  Google Scholar 

  17. Berend K, Gunneson E, Urbaniak J, Vail T. Free vascularized fibular grafting for the treatment of postcollapse osteonecrosis of the femoral head. J Bone Joint Surg Am. 2003;85-A(6):987–93.

    Article  PubMed  Google Scholar 

  18. Veillete CJ, Mehdian H, Schemitsch EH, McKee MD. Survivorship analysis and radiographic outcome following tantalum rod insertion for osteonecrosis of the femoral head. J Bone Joint Surg Am. 2006;88(3):48–55.

    Google Scholar 

  19. Tanzer M, Bobyn JD, Krygier JJ, Karabasz D. Histopathologic retrieval analysis of clinically failed porous tantalum osteonecrosis implants. J Bone Joint Surg Am. 2008;90(6):1282–9.

    Article  CAS  PubMed  Google Scholar 

  20. Mao Q, Wang W, Xu T. Combination treatment of biomechanical support and targeted intra-arterial infusion of peripheral blood stem cells mobilized by granulocyte-colony stimulating factor for the osteonecrosis of the femoral head: a randomized controlled clinical trial. J Bone Miner Res. 2015;30(4):647–56.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Sugioka Y, Yamamoto T. Transtrochanteric posterior rotational osteotomy for osteonecrosis. Clin Orthop Relat Res. 2008;466(5):1104–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 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.

    Article  CAS  PubMed  Google Scholar 

  23. Mont M, Cherian J, Sierra R, Jones L, Lieberman J. Nontraumatic osteonecrosis of the femoral head: where do we stand today? J Bone Joint Surg Am. 2015;97:604–27.

    Article  Google Scholar 

  24. Kim SM, Lim SJ, Moon YW, Kim YT, Ko KR, Park YS. Cementless modular total hip arthroplasty in patients younger than fifty with femoral head osteonecrosis: minimum fifteen-year follow-up. J Arthroplasty. 2013;28(3):504–409.

    Article  PubMed  Google Scholar 

  25. 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 Arthroplasty. 2013;28(7):1192–9.

    Article  PubMed  Google Scholar 

  26. Issa K, Naziri Q, Maheshwari A, Rasquinha V, Delanois R, Mont M. 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;28:1693–8.

    Article  PubMed  Google Scholar 

  27. Kim YH, Park JW, Kim JS. Cementless metaphyseal fitting anatomic total hip arthroplasty with a ceramic-on-ceramic bearing in patients thirty years of age or younger. J Bone Joint Surg Am. 2012;94:1570–5.

    Article  PubMed  Google Scholar 

  28. Kim YH, Kim JS, Park JW, Joo JH. Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head. J Bone Joint Surg Am. 2011;92:675–81.

    Google Scholar 

  29. Han S, Lee J, Kim J, Oh C, Kim S. Long-term durability of the CLS femoral prosthesis in patients with osteonecrosis of the femoral head. J Arthroplasty. 2013;28(5):828–31.

    Article  PubMed  Google Scholar 

  30. Min BW, Song KS, Bae KC, Cho CH, Lee KJ, Kim HJ. Second-generation cementless total hip arthroplasty in patients with osteonecrosis of the femoral head. J Arthroplasty. 2008;23(6):902–10.

    Article  PubMed  Google Scholar 

  31. Solarino G, Piazzolla A, Notarnicola A, Moretti L, Tafuri S, DeGiorgi S, Moretti B. Long-term results of 32-mm alumina-on-alumina THA for avascular necrosis of the femoral head. J Orthop Traumatol. 2012;13:21–7.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Koch P, Tannast M, Fujita H, Siebenrock K, Ganz R. Minimum ten year results of total hip arthroplasty with the acetabular reinforcement ring in avascular osteonecrosis. Int Orthop. 2008;32(2):173–9.

    Article  PubMed  Google Scholar 

  33. Nich C, Courpied J, Kerboull M, Postel M, Hamadouche M. Charnley-Kerboull total hip arthroplasty for osteonecrosis of the femoral head a minimal 10-year follow-up study. J Arthroplasty. 2006;21(4):533–40.

    Article  PubMed  Google Scholar 

  34. Xenakis T, Gelalis J, Koukoubis T, Zaharis K, Soucacos P. Cementless hip arthroplasty in the treatment of patients with femoral head necrosis. Clin Orthop Relat Res. 2001;386:93–9.

    Article  Google Scholar 

  35. 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;468:375–81.

    Article  PubMed  Google Scholar 

  36. Sayeed S, Johnson A, Stroh A, Gross T, Mont M. Hip resurfacing in patients who have osteonecrosis and are 25 years or under. Clin Orthop Relat Res. 2011;469:1582–8.

    Article  PubMed  Google Scholar 

  37. Nakasone S, Takao M, Sakai T, Nishii T, Sugano N. Does the extent of osteonecrosis affect the survival of hip resurfacing? Clin Orthop Relat Res. 2013;471:1926–34.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mont M. CORR insights: does the extent of osteonecrosis affect the survival of hip resurfacing? Clin Orthop Relat Res. 2013;471:1935–6.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA

    William C. Pannell MD (Orthopaedic Resident) & Jay R. Lieberman MD

  2. Biomedical Engineering, Viterbi School of Engineering of USC, Los Angeles, CA, USA

    Jay R. Lieberman MD

Authors
  1. William C. Pannell MD
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  2. Jay R. Lieberman MD
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Corresponding author

Correspondence to Jay R. Lieberman MD .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Rochester, Minnesota, USA

    Rafael J. Sierra

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© 2017 Mayo Foundation for Medical Education and Research

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Pannell, W.C., Lieberman, J.R. (2017). Osteonecrosis of the Femoral Head. In: Sierra, R. (eds) Osteonecrosis of the Femoral Head. Springer, Cham. https://doi.org/10.1007/978-3-319-50664-7_8

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  • DOI: https://doi.org/10.1007/978-3-319-50664-7_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50662-3

  • Online ISBN: 978-3-319-50664-7

  • eBook Packages: MedicineMedicine (R0)

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