Osteonecrosis of the femoral head: An update in year 2012

Abstract

Osteonecrosis is a phenomenon involving disruption to the vascular supply to the femoral head, resulting in articular surface collapse and eventual osteoarthritis. Although alcoholism, steroid use, and hip trauma remain the most common causes, several other etiologies for osteonecrosis have been identified. Basic science research utilizing animal models and stem cell applications continue to further elucidate the pathophysiology of osteonecrosis and promise novel treatment options in the future. Clinical studies evaluating modern joint-sparing procedures have demonstrated significant improvements in outcomes, but hip arthroplasty is still the most common procedure performed in these affected younger adults. Further advances in joint-preserving procedures are required and will be widely studied in the coming decade.

Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis

“…Osteonecrosis involves compromise of the epiphysis blood supply with frequent ensuing collapse of the articular surface and residual deformity of the hip [44,90]. Diagnosis and treatment are hindered by a substantial interval between initial obstruction of the vascular supply and onset of discernible radiographic anomalies [17].…”

Rehabilitation Program after Cell Therapy for Treatment of Femoral Head Osteonecrosis: A Narrative Review of Literature

“…Seventeen publications met the inclusion criteria and were included ( Figure 1). Publications were excluded based on the following criteria: (1) review article; (2) clinical trials on other diseases; (3) animal subjects; (4) patients <18 years of age; and (5) undescribed rehabilitation program (Figure 1). Treatment using cell therapy was performed in combination with CD surgery [4,[6][7][8][9][10][11][12][13][14][15] or debridement of necrotic bone surgery [15][16][17][18][19][20][21] (Table 1).…”

“…The inclusion criteria were as follows: (1) clinical trials including clinical cases for the treatment of idiopathic osteonecrosis of the femoral heads in humans; (2) treatment was performed by cell transplantation; (3) participants were 18 years old and above; (4) rehabilitation program was described; and (5) the publication was written in English.…”

“…ONFH is a painful disorder and progresses to femoral head collapse, which results in osteoarthritis of the hip joint in young adult [1]. Numerous joint-preserving procedures, such as core decompression (CD) surgery, osteotomy surgery, and physiotherapy, have been performed [2]. Recent development in the clinical application of cell therapy is expected to promote the joint-preserving procedure.…”

The Effect of Cape on Steroid Induced Osteonecrosis of the Femoral Head in Rat Model

“…Annually, 50,000 new cases of ONFH is reported in USA 3,4) . Unfortunately, there is not an effective treatment of ONFH, but generally definitive treatment with total hip arthroplasty is provided 5) . Steroid-induced ONFH, constitutes an important part of nontraumatic osteonecrosis 4,6) .…”