Abstract
Osteonecrosis of the femoral head (ONFH) is a rapidly progressive degenerative disease
frequently affecting individuals within their fourth and fifth decade of life. Though
often asymptomatic, patients with ONFH may present with a wide range of symptoms,
including deep groin pain. There are many classification systems used to stratify
disease severity, of which the Association of Research Circulation Osseous (ARCO)
classification system is currently the most comprehensive. Once diagnosed, an estimated
75% of patients will experience femoral head collapse within three years of diagnosis
if left untreated. Currently, the only definitive intervention available for ONFH
is total hip arthroplasty (THA). However, recent advancements have been made with
respect to the available treatment modalities. In this article, the author review
the management of ONFH, providing clinicians with the necessary information to counsel
their patients.
Keywords
osteonecrosis of the femoral head - bone marrow aspirate concentrate - stem cells
- core decompression - bisphosphonates - hyperbaric oxygen therapy - shockwave therapy
- vascularized fibular grafts - vascularized iliac grafts