Osteonecrosis of the Hip
Osteonecrosis of the hip is a painful condition that occurs when the blood supply to the femoral head is disrupted, causing bone cells in the head to die. The femoral head is the ball-like portion at the top of the thighbone that sits in the cup-like depression in the pelvic bone known as the acetabulum. As death of the femoral head bone ensues, the head collapses. This in turn leads to death and collapse of the articular cartilage that covers the surface of the femoral head. The result is a markedly deformed joint and arthritis. Osteonecrosis of the hip is also known as avascular necrosis or aseptic necrosis of the hip. It may also be called avascular or aseptic necrosis of the femoral head.
Here at YourOrthoSolution, we have some of the top orthopedic surgeons and sports medicine physicians in the country. We are dedicated to getting you back to the things you love through a customized plan that fits only you. Our caring team always goes that extra step to make you feel like part of our family. We specialize in treating conditions like osteonecrosis of the hip and want to help you start the healing process as quickly as possible to get you on the path to recovery.
Cause
Several factors that may increase the likelihood of developing osteonecrosis are:
- Previous injuries to the hip – such as hip dislocation or fracture
- Excessive alcohol use
- Oral corticosteroid medications – which may be taken for such conditions as asthma, rheumatoid arthritis, and systemic lupus erythematosus
- Various other diseases – such as Caisson disease (also known as diver’s disease or “the bends”), sickle cell disease, myeloproliferative disorders, Gaucher’s disease (a rare genetic disease with many abnormalities including fragile bones), systemic lupus erythematosus, Crohn’s disease, blood clots, and vasculitis (inflammation of blood vessels)
Osteonecrosis most commonly occurs in people 40 to 65 years of age. It is also more common in men than women.
Symptoms
Osteonecrosis typically develop in stages, and the symptoms increase as the disease gets worse. Hip pain is typically the first symptom. This may lead to a dull ache or throbbing pain in the groin or buttock. As the disease progresses, it will become more difficult to stand and put weight on the affected hip, and moving the hip joint will be painful. It may take several months to over a year for the disease to progress through these stages, depending on the individual.
Treatment
Some researchers have shown that earlier treatment is associated with better outcomes. Thus, it is important to diagnose osteonecrosis early in the course of the disease and begin treatment as soon as possible.
Nonsurgical
Nonsurgical treatments, such as medications and the use of crutches, can reduce pain and slow the progression of the disease. However, they are generally only temporizing measures, as most people require surgery.
Surgical
The most successful treatment for osteonecrosis of the hip is surgery. The main surgical options are:
- Core decompression
- Vascularized fibula graft
- Total hip replacement
For people diagnosed in the very stages of the disease — prior to collapse of the femoral head — the first two procedures may be useful. However, if femoral collapse has occurred, the best treatment is total hip replacement. This involves removing the femoral head, as well as the cartilage and bone in the area of the acetabulum, then replacing these structures with metal or plastic joint surfaces. Total hip replacement has a high success rate, relieving pain and restoring function in 90 to 95 percent of people.
At YourOrthoSolution, all of our doctors and staff are committed to ensuring that you not only receive the best orthopedic care in the area but also have an exceptional experience each time you visit our locations. Our dedicated staff will handle all insurance processes for you. You can expect to be in a friendly atmosphere and receive top orthopedic treatment to help you return to full mobility as quickly as possible.
