Joint-preserving procedures for osteonecrosis of the femoral head

[摘要] Osteonecrosis of the femoral head (ONFH) is a multifactorial and poorly understood disease predominantly encountered in patients in their third to fifth decade of life.1 This pathology results from disruption of the subchondral blood supply to the femoral head and constitutes a reason for total hip arthroplasty (THA) in young patients.1,2 If left undiagnosed and untreated, this disease will progress to the eventual collapse of the femoral head.1-3 Males are three times more affected than females, and bilateral ONFH is found in up to 75% of cases.4,5 In general, osteonecrosis is responsible for approximately 5–18% of all THA cases.6-8 In most countries, the incidence and prevalence of avascular necrosis (AVN) are reported based on unreliable data consisting of rough estimates on the rate of osteonecrosis. Chronic alcohol consumption and steroid administration are the most common aetiologies. Asian populations are considered to be more prone to developing AVN; in China, the number of new appearances is about 75,000−150,000 per year. Nationwide surveys from Japan and Korea reported the annual prevalence at more than 10,000 cases. In Taiwan, about half of the total number of hip arthroplasties were carried out due to femoral head osteonecrosis.

[学科分类] 神经科学

[关键词] avascular necrosis;core decompression;femoral head;hip;osteonecrosis;total hip arthroplasty