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The Journal of Hip Surgery 2019; 03(03): 142-150
DOI: 10.1055/s-0039-1693422
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Osteonecrosis of the Femoral Head: Can Arthroplasty be Avoided—A Brief Review of Common Interventions

Thomas A. Einhorn
1   Department of Orthopedic Surgery, NYU Langone Health, Langone Orthopedic Hospital, New York
,
Afshin A. Anoushiravani
2   Department of Orthopaedic Surgery, Albany Medical Center, Albany, New York
,
Kevin K. Chen
1   Department of Orthopedic Surgery, NYU Langone Health, Langone Orthopedic Hospital, New York
,
Thomas Draper
2   Department of Orthopaedic Surgery, Albany Medical Center, Albany, New York
,
Tony Tsismenakis
1   Department of Orthopedic Surgery, NYU Langone Health, Langone Orthopedic Hospital, New York
,
Richard Iorio
1   Department of Orthopedic Surgery, NYU Langone Health, Langone Orthopedic Hospital, New York
› Author Affiliations
Further Information

Publication History

07 May 2018

18 April 2019

Publication Date:
30 July 2019 (online)

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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
 

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