Current trends and controversies in femoral head osteonecrosis
Keywords:
osteonecrosis; femoral head; MRI; corticosteroids; COVID-19
Abstract
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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References
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2. Mont MA, Salem HS, Piuzzi NS, Goodman SB, Jones LC. Nontraumatic osteonecrosis of the femoral head: where do we stand today? A 5-Year Update. J Bone Joint Surg Am 2020; 102(12): 1084-99. doi: 10.2106/JBJS.19.01271.
3. Lieberman JR, Berry DJ, Mont MA, et al. Osteonecrosis of the hip: management in the 21st century. Instr Course Lect 2003; 52: 337-55.
4. Zalavras C, Dailiana Z, Elisaf M, et al. Potential aetiological factors concerning the development of osteonecrosis of the femoral head. Eur J Clin Invest 2000; 30(3): 215-21. doi: 10.1046/j.1365-2362.2000.00621.x.
5. Carli A, Albers A, Séguin C, et al. The medical and surgical treatment of ARCO Stage-I and II osteonecrosis of the femoral head: A Critical Analysis Review. JBJS Rev 2014; 2(2): e2. doi: 10.2106/JBJS.RVW.M.00066.
6. Seamon J, Keller T, Saleh J, et al. The pathogenesis of nontraumatic osteonecrosis. Arthritis 2012; 2012:601763. doi: 10.1155/2012/601763
7. Mankin HJ. Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 1992; 326(22): 1473-9. doi: 10.1056/NEJM199205283262206
8. Anderson PA, Jeray KJ, Lane JM, et al. Bone Health Optimization: Beyond Own the Bone: AOA Critical Issues. J Bone Joint Surg Am 2019; 101(15): 1413-19. doi: 10.2106/JBJS.18.01229.
9. Petek D, Hannouche D, Suva D. Osteonecrosis of the femoral head: pathophysiology and current concepts of treatment. EFORT Open Rev 2019; 4(3): 85-97. doi: 10.1302/2058-5241.4.180036.
10. Cui Q, Jo WL, Koo KH, et al. ARCO Consensus on the pathogenesis of non-traumatic osteonecrosis of the femoral head. J Korean Med Sci 2021; 36(10): e65. doi: 10.3346/jkms.2021.36.e65.
11. Tektonidou MG, Moutsopoulos HM. Immunologic factors in the pathogenesis of osteonecrosis. Orthop Clin North Am 2004; 35(3): 259-63. doi: 10.1016/j.ocl.2004.02.003.
12. Winquist EW, Bauman GS, Balogh J. Nontraumatic osteonecrosis after chemotherapy for testicular cancer: a systematic review. Am J Clin Oncol 2001; 24(6): 603-6. doi: 10.1097/00000421-200112000-00015.
13. Dzik-Jurasz AS, Brooker S, Husband JE, Tait D. What is the prevalence of symptomatic or asymptomatic femoral head osteonecrosis in patients previously treated with chemoradiation? A magnetic resonance study of anal cancer patients. Clin Oncol (R Coll Radiol) 2001; 13(2): 130-4. doi: 10.1053/clon.2001.9236.
14. Cui Q, Wang Y, Saleh KJ, et al. Alcohol-induced adipogenesis in a cloned bone-marrow stem cell. J Bone Joint Surg Am 2006; 88(Suppl 3): 148-54. doi: 10.2106/JBJS.F.00534.
15. Motomura G, Yamamoto T, Miyanishi K, et al. Bone marrow fat-cell enlargement in early steroid-induced osteonecrosis--a histomorphometric study of autopsy cases. Pathol Res Pract 2005; 200(11-12): 807-11. doi: 10.1016/j.prp.2004.10.003.
16. Lespasio MJ, Sodhi N, Mont MA. Osteonecrosis of the Hip: A Primer. Perm J 2019; 23:18-100. doi: 10.7812/TPP/18-100.
17. Wang A, Ren M, Wang J. The pathogenesis of steroid-induced osteonecrosis of the femoral head: A systematic review of the literature. Gene 2018; 671: 103-109. doi: 10.1016/j.gene.2018.05.091.
18. Yoon BH, Jones LC, Chen CH, et al. Etiologic classification criteria of ARCO on femoral head osteonecrosis Part 1: Glucocorticoid-Associated Osteonecrosis. J Arthroplasty 2019; 34(1): 163-168. doi: 10.1016/j.arth.2018.09.005.
19. Yoon BH, Jones LC, Chen CH, et al. Etiologic classification criteria of ARCO on femoral head osteonecrosis Part 2: Alcohol-associated osteonecrosis. J Arthroplasty 2019; 34(1): 169-174. doi: 10.1016/j.arth.2018.09.006.
20. Kannu P, O’Rielly DD, Hyland JC, et al. Avascular necrosis of the femoral head due to a novel C propeptide mutation in COL2A1. Am J Med Genet A 2011; 155A(7): 1759-62. doi: 10.1002/ajmg.a.34056.
21. Wang Y, Xia CJ, Wang BJ, et al. The association between VEGF -634C/G polymorphisms and osteonecrosis of femoral head: a meta-analysis. Int J Clin Exp Med 2015; 8(6): 9313-9.
22. Wyles CC, Paradise CR, Houdek MT, et al. Disruption in peroxisome proliferator-activated receptor-γ (PPARG) increases osteonecrosis risk through genetic variance and pharmacologic modulation. Clin Orthop Relat Res 2019; 477(8): 1800-12. doi: 10.1097/CORR.0000000000000713.
23. Rezus E, Tamba BI, Badescu MC, et al. Osteonecrosis of the femoral head in patients with hypercoagulability-from pathophysiology to therapeutic implications. Int J Mol Sci 2021; 22(13): 6801. doi: 10.3390/ijms22136801.
24. Wang T, Azeddine B, Mah W, et al. Osteonecrosis of the femoral head: genetic basis. Int Orthop 2019; 43(3): 519-530. doi: 10.1007/s00264-018-4172-8
25. Hines JT, Jo WL, Cui Q, et al. Osteonecrosis of the femoral head: an updated review of ARCO on pathogenesis, staging and treatment. J Korean Med Sci 2021; 36(24): e177. doi: 10.3346/jkms.2021.36.e177.
26. Luo P, Gao F, Han J, et al. The role of autophagy in steroid necrosis of the femoral head: a comprehensive research review. Int Orthop 2018; 42(7): 1747-53. doi: 10.1007/s00264-018-3994-8.
27. Hyakuna N, Shimomura Y, Watanabe A, et al. Assessment of corticosteroid-induced osteonecrosis in children undergoing chemotherapy for acute lymphoblastic leukemia: a report from the Japanese Childhood Cancer and Leukemia Study Group. J Pediatr Hematol Oncol 2014; 36(1): 22-9. doi: 10.1097/MPH.0000000000000039.
28. Sherief LM, Beshir M, Raafat N, et al. Genetic polymorphism of vitamin D receptors and plasminogen activator inhibitor-1 and osteonecrosis risk in childhood acute lymphoblastic leukemia. Mol Genet Genomic Med 2021; 9(7): e1700. doi: 10.1002/mgg3.1700.
29. Amin N, Kinsey S, Feltbower R, et al. British OsteoNEcrosis Study (BONES) protocol: a prospective cohort study to examine the natural history of osteonecrosis in older children, teenagers and young adults with acute lymphoblastic leukaemia and lymphoblastic lymphoma. BMJ Open 2019; 9(5): e027204. doi: 10.1136/bmjopen-2018-027204.
30. Tang C, Wang Y, Lv H, et al. Caution against corticosteroid-based COVID-19 treatment. Lancet 2020; 395(10239): 1759-1760. doi: 10.1016/S0140-6736(20)30749-2
31. Guo KJ, Zhao FC, Guo Y, et al. The influence of age, gender and treatment with steroids on the incidence of osteonecrosis of the femoral head during the management of severe acute respiratory syndrome: a retrospective study. Bone Joint J 2014; 96-B(2): 259-62. doi: 10.1302/0301-620X.96B2.31935.
32. Chen F, Hao L, Zhu S, et al. Potential adverse effects of dexamethasone therapy on COVID-19 patients: review and recommendations. Infect Dis Ther 2021; 22: 1-25. doi: 10.1007/s40121-021-00500-z.
33. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet 2020; 395(10223): 473-75. doi: 10.1016/S0140-6736(20)30317-2
34. Choi HR, Steinberg ME, Y Cheng E. Osteonecrosis of the femoral head: diagnosis and classification systems. Curr Rev Musculoskelet Med 2015; 8(3): 210-20. doi: 10.1007/s12178-015-9278-7
35. Malizos KN, Karantanas AH, Varitimidis SE, et al. Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol 2007; 63(1): 16-28. doi: 10.1016/j.ejrad.2007.03.019
36. Zhang YZ, Cao XY, Li XC, et al. Accuracy of MRI diagnosis of early osteonecrosis of the femoral head: a meta-analysis and systematic review. J Orthop Surg Res 2018; 13(1): 167. doi: 10.1186/s13018-018-0836-8.
37. Zibis AH, Karantanas AH, Roidis NT, et al. The role of MR imaging in staging femoral head osteonecrosis. Eur J Radiol 2007; 63(1): 3-9. doi: 10.1016/j.ejrad.2007.03.029.
38. Stevens K, Tao C, Lee SU, et al. Subchondral fractures in osteonecrosis of the femoral head: comparison of radiography, CT, and MR imaging. AJR Am J Roentgenol. 2003 Feb;180(2):363-8. doi: 10.2214/ajr.180.2.1800363. PMID: 12540435.
39. Ng FH, Lai TKB, Lam SY, et al. Hybrid magnetic resonance imaging with single photon emission computed tomography/computed tomography bone scan for diagnosis of avascular necrosis of femoral head. J Clin Imaging Sci 2021; 11: 2. doi: 10.25259/JCIS_205_2020.
40. Korompilias AV, Karantanas AH, Lykissas MG, et al. Transient osteoporosis. J Am Acad Orthop Surg 2008; 16(8): 480-9. doi: 10.5435/00124635-200808000-00007
41. Yoon BH, Mont MA, Koo KH, et al. The 2019 revised version of association research circulation osseous staging system of osteonecrosis of the femoral head. J Arthroplasty 2020; 35(4): 933-40. doi: 10.1016/j.arth.2019.11.029
42. Schmitt-Sody M, Kirchhoff C, Mayer W, et al. Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications. Int Orthop 2008; 32(3): 283-7. doi: 10.1007/s00264-007-0320-2
43. Takashima K, Sakai T, Hamada H, et al. Which classification system is most useful for classifying osteonecrosis of the femoral head? Clin Orthop Relat Res 2018; 476(6): 1240-49. doi: 10.1007/s11999.0000000000000245
44. Cheng W, Xian H, Wang L, et al. Frog leg lateral view is a reliable predictor of the prognosis in osteonecrosis of the femoral head. J Orthop Res 2021; 39(5): 950-958. doi: 10.1002/jor.24825.
45. Banerjee S, Kapadia BH, Jauregui JJ, Cherian JJ, Mont MA. Natural history of osteonecrosis. In: Koo KH, Mont MA, Jones LC. (ed). Osteonecrosis. Springer- Heidelberg 2014, pp 161-164.
46. Lee GC, Steinberg ME. Are we evaluating osteonecrosis adequately? Int Orthop 2012; 36(12): 2433-9. doi: 10.1007/s00264-012-1658-7
47. Wu W, He W, Wei QS, et al. Prognostic analysis of different morphology of the necrotic-viable interface in osteonecrosis of the femoral head. Int Orthop 2018; 42(1): 133-9. doi: 10.1007/s00264-017-3679-8
48. Kwon HM, Yang IH, Park KK, et al. High pelvic incidence is associated with disease progression in nontraumatic osteonecrosis of the femoral head. Clin Orthop Relat Res 2020; 478(8): 1870-76. doi: 10.1097/CORR.0000000000001155.
49. Roth A, Beckmann J, Bohndorf K, et al. Arch Orthop Trauma Surg 2016; 136(2): 165-74.
50. Hua KC, Yang XG, Feng JT, et al. The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis. J Orthop Surg Res 2019; 14(1): 306. doi: 10.1186/s13018-019-1359-7.
51. Zhang Y, Wang Y, Chen J, et al. The top 100 cited articles in osteonecrosis of the femoral head: A bibliometric analysis. Biomed Res Int 2021; 2021: 1433684. doi: 10.1155/2021/1433684.
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Published
2022-03-24
Section
Review
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