Current trends and controversies in femoral head osteonecrosis
Keywords:
osteonecrosis; femoral head; MRI; corticosteroids; COVID-19Abstract
Osteonecrosis of the femoral head is a disabling disease with necrosis of bone and bone marrow occurring within the head that predictively leads to collapse of the subchondral infract if left untreated. Osteonecrosis can be either traumatic or non-traumatic associated with an array of systemic diseases and risk factors and frequently presents a multifocal distribution. Corticosteroids are considered a risk factor for osteonecrosis. Patients treated for myelogenous diseases and COVID-19 are particularly in elevated risk for developing osteonecrosis. At an early stage it is asymptomatic and undetectable in simple radiographs. MRI is the gold standard for diagnosis and should be prescribed early after corticosteroid therapy. Therapy is, in most cases, surgical and every attempt should be made to preserve the native joint in young patients. If articular surface collapse is established, total hip arthroplasty is the treatment of choice to maintain the quality of patients’ life.
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