10/8/2014 0 Comments
Special thanks to star physical therapist Antara Quiñones of Alpine Physical Therapy for providing this write up on a recent article from the Journal of American Academy of Orthopedic Surgery.
Osteonecrosis of the femoral head most frequently affects 30 to 50 year olds, with 20,000-30,000 new cases diagnosed annually. Although the actual pathology behind femoral osteonecrosis is not yet understood, the disease typically follows a progression to eventual femoral collapse, which results in the need for a total hip replacement.
Osteonecrosis literally translates to bone death. There are several reasons why this can occur. Ischemia, or lack of blood flow, is one. This can happen from trauma, (like a hip dislocation or fracture), a blood clot blocking blood flow, or high blood pressure at the level of the bone tissue from excessive alcohol or corticosteroid use. Some genetic blood clot formation mutations have also been linked to femoral osteonecrosis. Disruption to the bone cells themselves by irradiation, chemotherapy, or the presence of excessive free radicals, also causes osteonecrosis. Primary risk factors include corticosteroid use, alcoholism, trauma, and coagulation disorders. They have found, however that a risk factor alone does not determine the onset of osteonecrosis, but that there must also be a genetic factor present.
The earlier the disease is diagnosed, the better the outcome. The most frequent symptom is deep groin pain that can radiate to the buttock or knee on the same side. The gold standard for femoral osteonecrosis detection is an MRI, which can give insight into the amount of bone death present, its location, and the amount of swelling in the bone. All of this information can help physicians treat the problem and predict whether or not the femoral head will “collapse.” which then means a need for a total hip replacement.
Nonsurgical treatment of femoral osteonecrosis is limited to smaller, symptom free lesions for a period of no weight bearing to see if symptoms do occur. Little evidence exists backing shockwaves and electromagnetic field treatment. Pharmacologic agents are also not strongly backed in the literature for prevention and treatment of femoral osteonecrosis.
Surgical treatment is the primary treatment option for femoral head osteonecrosis and consists of femoral head preserving procedures or total hip replacement. The type of femoral head preserving procedure is subject to debate and dependent on the extent and location of the bone death. Femoral head sparing procedures are also indicated for the younger patient.
Charalampos G. Zalavras, M.D. and Jay R. Lieberman, M.D. Osteonecrosis of the Femoral Head: Evaluation and Treatment. The Journal of American Academy of Orthopedic Surgery. July, 2014. Vol. 22, No. 7. Pp 455-464.
For more information, visit our topic module on this topic on our clinic website by clicking here.
All Alpine Physical Therapy Alpine Soccer Team Alpine Softball Alzheimer's Disease American Cancer Society Ana Soulia Angela Listug Vap Angela Listug-Vap Ankle Sprains Antara Quinones Aquatics Audrey Elias Back Pain Balance Biking Boston Marathon Brace Hayden Brent Dodge Cancer CDC Certified Chiropractic Climbing Concussion CoreAlign Core Studio Crossfit Dance Medicine Dennis McCrea Diabetes Diane Cummins Diva Day Dr. Liz Walker Eating Emily Jones Ergonomics Events Excercises Fall Prevention Fall Prevention Awareness Day Fishing Fitness Fit To Fight Foot Pain Functional Dry Needling Gary Gales Golf Good Food Store Headaches Health Her Health Hiking Hip Pain Jamie Terry Jeannette Kittredge Jessica Kehoe Jonathan Hoffman's Foundation Training Josie Sweeney Kayla Johnson Kerri Houck Knee Pain Kristi Moore Leah Versteegen Lindsy Campbell Linsey Olson Low Back Pain LYMPHEDEMA Mary Mischke Matt Schweitzer MISA Missoula Marathon Missoula's Choice Moms Montana Geriatric Society Morgan York Singer Morgan York-Singer MT Alpha Cycling National Cancer Institute National Falls Awareness Neck Pain Oncology Rehab Program Pain Pamela Pack Peak Health & Wellness Center Peak Triathlon Pelvic Pain Physical Therapy Physical Therapy (Journal) Pilates Primal Practice Relay For Life Resources Roger Sperry Ron Clijsen Ron Veilleux Runner's Edge Running Samantha Glaes Sam Schmidt Sarah McMillan Shoulder Pain Sitting Skiing Skye Folsom Soccer Spine Magazine Spine Rehab Sports STEADI (Stopping Elderly Accidents Tai Chi Tamarack Brewing Company Tara Mund The Runner's Clinic Tips Travis Dye Ultrasound Imaging University Of Montana Urinary Incontinence Walking Wellness Wellness Program Westside Dance Physical Therapy Who Is Perfect? Women's Health
Connect with us
Get to know us better. Our social media platforms are a great way to learn about our staff, upcoming events, newest technology, patient stories, and more.
who we are
Leading innovation in health and wellness for our community, delivering compassionate care, and inspiring through education.
Know what’s new. Plus, get a free consultation!
Copyright © 2020 Alpine Physical Therapy • All Rights Reserved
Site by Aesir Consulting
Site by Aesir Consulting