hip HIP OSTEONECROSIS
DEFINITION:
- Also known as “Aseptic necrosis” or “Avascular necrosis”.
- A process whereby the bone of the femoral head dies with the subsequent collapse and deformity. (See illustration).
MECHANISM OF INJURY / HOW IT OCCURS:
- A result of disruption of the blood supply to the femoral head often a result of trauma, such as fracture or dislocation. Other causes include a history of steroid use, alcohol abuse, amongst other diseases.
- The collapse of bone and overlying cartilage leads to the development of progressive arthritic changes.
SYMPTOMS:
- Individuals complain of thigh, groin, or buttock pain.
- Limited motion and limp may develop.
DIAGNOSIS:
- Physical examination reveals pain with range of motion testing.
- Limp and a painful gait may be observed.
- Radiographic studies to include plain x-rays and Magnetic resonance imaging (MRI) will confirm diagnosis.
TREATMENT/REHABILITATION:
- Initially protected weight bearing with crutches.
- For persistent and progressive symptoms surgical options are considered. One option is core decompression where a core of bone is removed from the femoral head thus decreasing pressure and promoting blood flow. For more advanced stages, hip arthroplasty (replacement) is considered.