In order to investigate the mechanisms of collapse in osteonecrosis of the femoral head, we examined which part of the femoral head was the key point of a collapse and whether a collapsed region was associated with the size of the necrotic lesion. Using 30 consecutive surgically removed femoral heads we retrospectively analysed whole serial cut sections, specimen photographs, specimen radiograp...

Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and ...

BACKGROUND Hip resurfacing is a conservative type of total hip arthroplasty but its use is controversial, especially in patients with osteonecrosis. The aim of this study was analysis of the clinical and radiographic outcomes of hip resurfacing in patients with osteonecrosis. MATERIAL/METHODS Between 2007 and 2008, 30 hip resurfacing arthroplasties were performed due to osteoarthritis seconda...

Observations of the disease course mainly by X-ray were made in 52 patients (85 joints) with avascular necrosis of the femoral head to determine the prognosis and to decide on treatment. The progression of the necrotic area is related to the activity of the original disease, to the size of the necrotic area in the early stages of the disease, and to whether or not the patient received steroid t...

Our understanding of idiopathic necrosis of the femoral head depends upon two fundamental concepts. The first is that a standard radiograph shows only the shadow of the mineralised portion of a bone. The radiographic appearance of living bone is the same as that of dead bone ofEgyptian mummies or prehistoric skeletons. Consequently, bone necrosis has no specific radiographic appearance and a no...

We studied the natural history of nontraumatic avascular necrosis of the femoral head (ANFH) in 115 hips in 87 patients, 69 steroid-induced, 21 related to misuse of alcohol and 25 idiopathic. The average length of follow-up was over five years. Collapse occurred most often when the focus of bone necrosis occupied the weight-bearing surface of the femoral head. Flatness of the head due to subcho...

The cause of fracture of the femoral neck after hip resurfacing is poorly understood. In order to evaluate the role of avascular necrosis we compared 19 femoral heads retrieved at revision for fracture of the femoral neck and 13 retrieved for other reasons. We developed a new technique of assessing avascular necrosis in the femoral head by determining the percentage of empty osteocyte lacunae p...

Two patients are described, each with a fracture-dislocation of the hip combined with a fracture of the neck of the same femur. Open reduction combined with internal fixation was performed in both cases. Eight years later one patient had developed avascular necrosis of the femoral head; no signs of avascular necrosis or associated arthritis have appeared in the other patient after four years. A...

Osteonecrosis or avascular necrosis (AVN) is a pathologic process that results from a critical decrease of blood supply to the bone and elevated intraosseous pressure [1]. While the pathogenic process is not clear, it is believed that osteonecrosis is the final common pathway of traumatic and non-traumatic insults and that it impairs blood circulation to the femoral head. Subsequently, interrup...