Etiologies and outcome of osteonecrosis of the femoral head: Etiology and outcome study in a Taiwan population

Tsai, Shi-Chun; Wu, Po Kuei; Chen, Cheng Fong; Chiang, Cheng‐Chin; Huang, Ching Kuei; Chen, Tain Hsiung; Liu, Chien Lin; Chen, Wei Ming

doi:10.1016/j.jcma.2015.07.010

Cited by 41 publications

(35 citation statements)

References 19 publications

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“…Genetic factors may also play a significant role (10). Nonidiopathic osteonecrosis patients had the worst outcome (11). Patients with sickle cell disease have a high likelihood of progressing to head collapse.…”

Section: Patient Assessment and Classificationmentioning

confidence: 99%

Hip replacement in femoral head osteonecrosis: current concepts

Scaglione

Fabbri

Celli

et al. 2015

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SummaryOsteonecrosis of the femoral head is a destructive disease that usually affects young adults with high functional demands and can have devastating effects on hip joint. The treatment depends on extent and location of the necrosis lesion and on patient's factors, that suggest disease progression, collapse probability and also implants survival. Non-idiopathic osteonecrosis patients had the worst outcome. There is not a gold standard treatment and frequently it is necessary a multidisciplinary approach. Preservation procedures of the femoral head are the first choice and can be attempted in younger patients without head collapse. Replacement procedure remains the main treatment after failure of preserving procedures and in the late-stage ONFH, involving collapse of the femoral head and degenerative changes to the acetabulum. Resurfacing procedure still has good results but the patient selection is a critical factor. Total hip arthroplasties had historically poor results in patients with osteonecrosis. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems.

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Section: Patient Assessment and Classificationmentioning

confidence: 99%

Hip replacement in femoral head osteonecrosis: current concepts

Scaglione

Fabbri

Celli

et al. 2015

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“…12 Though exact mechanism is not known various theories have suggested role of increased adipocyte volume, increased intra-osseous pressure and fat embolism as final mechanisms. 13 Tsai et al 14 from Taiwan found that alcohol consumption was the most common etiology contributing to 45.2% cases of ONFH, followed by idiopathic AVN in 33.1% and steroid induced AVN in 21.7%. In total 59.1% cases were bilateral.…”

Section: Discussionmentioning

confidence: 99%

Osteo-necrosis of femoral head in North Indian population: Risk factors and clinico-radiological correlation

Goyal

Singh

Sharma

et al. 2019

Clinical Epidemiology and Global Health

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Introduction: Osteonecrosis of femoral head (ONFH) is a common cause of destruction of hip joint in young patients and is one of the commonest indications of total hip replacement in India and other Asian countries. Data on risk factors for avascular necrosis and their relation to clinical and radiological outcomes is scarce. This study will help to understand the epidemiology of the condition and quantitatively define risk of disease with exposure to various known risk factors. Materials and methods: 100 patients diagnosed to have ONFH and 100 matched controls were included in this prospective study. Details regarding alcohol consumption and steroid use were taken. Association between Harris hip score & Visual analogue scale for pain and Ficat staging and area of femoral head involvement on MRI was studied. Association between amounts of alcohol and steroid consumed (average and cumulative doses) and clinical and radiological variables was also studied. Results: Corticosteroid exposure was present in 44%, alcohol in 30% patients and 22% cases were idiopathic. There was a statistically significant difference between average weekly alcohol consumption, drink-years, average daily dose of steroid and cumulative doses of steroids between the cases and the controls. Odds-ratio for steroid exposure in cases with ONFH was 134.5, 0.0006, and odds-ratio for alcohol exposure was 32.7, 0.0001. There was a significant correlation between the amount of alcohol (r = −0.348, p = 0.02) and steroid (r = −0.334, p = 0.001) consumption and HHS, and between amount of alcohol (r = 0.312, p = 0.035) and steroid (r = 0.546, p = 0.001) consumption and area of femoral head involvement. There was a strong positive correlation between clinical and radiological parameters (area of femoral head involved and HHS, r = −0.70, p = 0.000). Conclusion: Risk factors such as steroid intake and alcohol intake are important and accounts for majority of the cases of ONFH. The quantity of these exposures is directly related to the severity of disease on clinico-radiological scales.

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“…Avascular osteonecrosis is a pathological state where a reduced vascular supply leads to ischemia and bone necrosis. This have been reported in orthopedic literature [2,3] but only few cases described maxillary bone necrosis, in particular secondary to DIC. With regard to the oro-maxillo-facial sphere, avascular necrosis of the midface is a rare condition due to rich blood supply from the bilateral branches of the external carotide artery [4].…”

Section: Introductionmentioning

confidence: 97%

Avascular osteonecrosis of the premaxilla secondary to disseminated intravascular coagulation: a case report

Mouraret

Gérard

Gall

et al. 2018

J Oral Med Oral Surg

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Introduction: Disseminated intravascular coagulation (DIC) is a complexe systemic disorder characterized by a widespread activation of the coagulation, that may lead to thrombosis, ischemia and finally, end-organ failure. The clinical presentation of DIC depends on the site of intravascular coagulation and the severity of the disease process. Avascular osteonecrosis is a pathological state, that can occur secondary to DIC and where a reduced vascular supply leads to ischemia and bone necrosis. Observation: A 83 years old patient was sent to the oral surgery department for tooth mobility in the premaxilla, following the diagnosis of sepsis and DIC induced acute myeloid leukemia, one month ago. The examination showed an exposed avascular bone behind the 12-11-21. A diagnosis of DIC induced osteonecrosis of the premaxilla was made. A resection surgery was then programmed. Discussion: DIC may generates thrombi that might occlude intraosseous vessels in the premaxilla, and lead to bone necrosis. The maxilla is supplied by multiple branches of external carotide artery, therefore, usually, there is a lower risk of osteonecrosis in the maxilla. Nevertheless, since 1993, 4 cases of avascular necrosis of the maxilla secondary to DIC are repported in literature. Conclusion: This kind of complication, although being rare, can be dramatic for the patient as bone and aesthetic defects. Early support and management of these complications is necessary.

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Etiologies and outcome of osteonecrosis of the femoral head: Etiology and outcome study in a Taiwan population

Abstract: Alcohol use had the greatest impact on ONFH in our population. Nonidiopathic ONFH patients had the worst outcome. Understanding the nature of progression of ONFH and incidence of contralateral disease may provide great prognostic value to detect and perform early intervention.

Cited by 41 publications

References 19 publications

Hip replacement in femoral head osteonecrosis: current concepts

Hip replacement in femoral head osteonecrosis: current concepts

Osteo-necrosis of femoral head in North Indian population: Risk factors and clinico-radiological correlation

Avascular osteonecrosis of the premaxilla secondary to disseminated intravascular coagulation: a case report

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