ONFHOsteonecrosis of the Femoral Head
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Once the femoral head collapses and acetabular degeneration or secondary arthritis is present, a total hip arthroplasty (THA) is often the last and most reliable option.[1],[2],[3] Although studies of THA have normally demonstrated excellent results in greater than a 10-year follow-up period compared with that in patients with traumatic osteonecrosis of the femoral head (ONFH), those with nontraumatic ONFH tend to be younger and physically more active, and as a result, replaced hip joint may need to be revised.[1],[3],[4],[5],[6],[7],[8]
Patients and Methods: All cementless total hip arthroplasty (THA) patients operated for Osteonecrosis of femoral head (ONFH) in UNIT 3 were included.
ONFH is a multifactorial disease with different etiologies ranging from genetic to idiopathic to certain risk factors such as trauma, hematological disorders, and steroid intake [4].
For patients with ONFH, blood sampling to obtain PRP was not directly related to their treatment and accordingly the number of samples was limited.
Although improved outcomes have been observed for BMSC treatment compared with canonical core decompression, concerns about the remaining osteogenic capacity or proliferation of BMSCs in the repair of GC-induced ONFH [10-12] have limited the widespread use of this treatment.
The pathogenesis of nontraumatic ONFH is not completely clear, but it may be attributed to vascular injury, altered lipid metabolism/fat emboli, cell and bone death, mechanical stress, disruptive immune system, and defective bone repair [4, 6].
For some patients, ONFH was first recognized when they were receiving maintenance doses of corticosteroids for their autoimmune diseases.
El objetivo en el tratamiento de ONFH es la conservacion de la cabeza femoral, sin embargo, resulta dificil de lograrlo dado que la condicion se asocia a diversas enfermedades y a que ni la etiologia, ni la historia natural se han determinado de forma concluyente.
The collapse of femoral head has been linked to some biomechanical changes at the hip joint.[10],[11],[12] The lateral pillar of femoral head is considered as a key factor in the prediction of collapse of ONFH, but the biomechanical studies on such matter remain limited.[6],[13] Today, there are different approaches that can correctly and effectively address clinical questions in terms of ONFH and disease progression.
The purpose of this study was to analyze the clinical outcomes and 10-year follow-up of ONFH patients who underwent THAs using the minimally invasive two-incision and modified WJ approaches.
Corticosteroid-induced osteonecrosis of the femoral head (ONFH) is a debilitating disease primarily affecting younger, active populations.