Abstract
Osteonecrosis of the femoral head remains a treatment challenge in the young adult population. While the pathophysiology is often related to an interruption of blood flow to the femoral head that often leads to collapse, the underlying etiology is typically unknown. The preferred management of osteonecrosis is dependent on the stage of the disease, which is divided into pre-collapse and post-collapse stages. For pre-collapse lesions, the most common surgical treatment is core decompression and autologous bone grafting. This technique theoretically decreases the intraosseous pressure within the femoral head and encourages a local vascularized healing response. More recently, arthroscopic-assisted techniques have been developed to successfully address concomitant intraarticular pathologies in addition to performing a minimally invasive decompression.
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References
Nazal MR, Parsa A, Martin SD. Mid-term outcomes of arthroscopic-assisted Core decompression of Precollapse osteonecrosis of femoral head-minimum of 5 year follow-up. BMC Musculoskelet Disord. 2019;20:448.
Papavasiliou AV, Triantafyllopoulos I, Paxinos O, Tsoukas D, Kostantoulakis C. The role of cell therapies and hip arthroscopy in the management of osteonecrosis: an update. J Hip Preserv Surg. 2018;5:202–8.
Karkenny AJ, Tauberg BM, Otsuka NY. Pediatric hip disorders: slipped capital femoral epiphysis and Legg-Calvé-Perthes disease. Pediatr Rev. 2018;39:454–63.
Chi Z, Wang S, Zhao D, Wang B. Evaluating the blood supply of the femoral head during different stages of necrosis using digital subtraction angiography. Orthopedics. 2019;42:e210–5.
Ahmed G, Shiraz S, Riaz M, Ibrahim T. Late versus early reduction in traumatic hip dislocations: a meta-analysis. Eur J Orthop Surg Traumatol. 2017;27:1109–16.
LaPorte DM, Mont MA, Mohan V, Jones LC, Hungerford DS. Multifocal osteonecrosis. J Rheumatol. 1998;25:1968–74.
Cohen-Rosenblum A, Cui Q. Osteonecrosis of the femoral head. Orthop Clin North Am. 2019;50:139–49.
Malizos KN, Karantanas AH, Varitimidis SE, Dailiana ZH, Bargiotas K, Maris T. Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol. 2007;63:16–28.
Lieberman JR, Berry DJ, Mont MA, Aaron RK, Callaghan JJ, Rajadhyaksha AD, et al. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect. 2003;52:337–55.
Atilla B, Bakırcıoğlu S, Shope AJ, Parvızı J. Joint-preserving procedures for osteonecrosis of the femoral head. EFORT Open Rev. 2019;4:647–58.
Civinini R, De Biase P, Carulli C, Matassi F, Nistri L, Capanna R, et al. The use of an injectable calcium sulphate/calcium phosphate bioceramic in the treatment of osteonecrosis of the femoral head. Int Orthop. 2012;36:1583–8.
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Cancienne, J.M., Frank, R.M., Nho, S.J. (2022). Surgical Technique: Arthroscopic Core Decompression with Iliac Crest Bone Graft. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_154
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DOI: https://doi.org/10.1007/978-3-030-43240-9_154
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