The Journal of Bone and Joint Surgery (American). 2006;88:1117-1132.
doi:10.2106/JBJS.E.01041
© 2006 The Journal of Bone and Joint Surgery, Inc.
Nontraumatic Osteonecrosis of the Femoral Head: Ten Years Later
Michael A. Mont, MD1,
Lynne C. Jones, PhD2 and
David S. Hungerford, MD2
1 Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced
Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue,
Baltimore, MD 21215. E-mail address:
rhondamont{at}aol.com
2 Division of Arthritis Surgery, Department of Orthopaedic Surgery, The Johns
Hopkins University School of Medicine, Good Samaritan Hospital, Professional
Office Building, Suite G-1, 5601 Loch Raven Boulevard, Baltimore, MD
21239
Investigation performed at the Center for Joint Preservation and
Reconstruction, Rubin Institute for Advanced Orthopedics, Sinai Hospital of
Baltimore, and the Department of Orthopaedic Surgery, The Johns Hopkins
University School of Medicine, Good Samaritan Hospital, Baltimore,
Maryland
NOTE: The authors thank Dr. German Marulanda and Dr. Thorsten
Seyler for their help with research background material.
The authors did not receive grants or outside funding in support of their
research for or preparation of this manuscript. They did not receive payments
or other benefits or a commitment or agreement to provide such benefits from a
commercial entity. No commercial entity paid or directed, or agreed to pay or
direct, any benefits to any research fund, foundation, educational
institution, or other charitable or nonprofit organization with which the
authors are affiliated or associated.
The etiology of osteonecrosis of the hip may have a genetic basis. The
interaction between certain risk factors and a genetic predisposition may
determine whether this disease will develop in a particular individual.
The rationale for use of joint-sparing procedures in the treatment of this
disease is based on radiographic measurements and findings with other imaging
modalities.
Early diagnosis and intervention prior to collapse of the femoral head is
key to a successful outcome of joint-preserving procedures.
The results of joint-preserving procedures are less satisfactory than the
results of total hip arthroplasty for femoral heads that have already
collapsed.
New pharmacological measures as well as the use of growth and
differentiation factors for the prevention and treatment of this disease may
eventually alter our treatment approach, but it is necessary to await results
of clinical research with long-term follow-up of these patients.
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Letters to the Editor:
Read all Letters to the Editor
- Detection of Osteonecrosis on MRI Requires Blood Flow.
- James K. Brannon, M.D.
- JBJS Online, 5 Jul 2006
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