Avascular Necrosis of Femoral Head-Overview and Current State of the Art

Wojciech Konarski, Tomasz Poboży, Andrzej Śliwczyński, Ireneusz Kotela, Jan Krakowiak, Martyna Hordowicz, Andrzej Kotela, Wojciech Konarski, Tomasz Poboży, Andrzej Śliwczyński, Ireneusz Kotela, Jan Krakowiak, Martyna Hordowicz, Andrzej Kotela

Abstract

Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the proximal femur. The alterations in the blood supply may occur following a traumatic event or result from a non-traumatic cause. Femoral neck fracture and hip dislocation and associated surgical procedures, corticosteroid therapy, and alcohol abuse frequently lead to AVN development. Type of fracture (displaced or undisplaced) and time between injury and surgery are the most critical factors in assessing the risk of developing AVN. Diagnosis of AVN can be established based on patients' complaints, medical history, and radiographic findings. There is no consensus on the treatment of patients with AVN to date. Non-surgical methods are dedicated to patients in the early pre-collapse stages of the disease and consist of pharmacotherapy and physiotherapy. Surgery is recommended for patients with advanced disease.

Keywords: avascular necrosis; femoral head; implants; osteonecrosis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Avascular necrosis of right femoral head following stabilization of intertrochanteric fracture. (A) Posteroanterior view of the fracture; posteroanterior (B) view after 12 weeks of procedure; (C) view at a follow-up visit 20 weeks after the procedure, prominent necrosis of right femoral head; R—right.
Figure 2
Figure 2
Posteroanterior view of internal fixation of left femoral neck fracture using the dynamic hip screw. (A) Posteroanterior view directly after the procedure; (B) posteroanterior view during control 15 weeks after the procedure, prominent necrosis of left femoral head.
Figure 3
Figure 3
The posteroanterior view shows a right (R) AVN of the femoral head (T1-weighted).
Figure 4
Figure 4
Arthroplasty of the left hip due to avascular necrosis of the femoral head.

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