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Hoại tử xương đùi

New hộp hoại tử xương đùi của người đứng đầu tại Hoa Kỳ giữa 10,000 và số 20,000 mỗi năm. Thông thường bệnh này ảnh hưởng đến bệnh nhân trong độ tuổi cuối 30 và đầu 40 của họ. Mặc dù một số tác giả có yếu tố nguy cơ cụ thể liên quan đến bệnh này, STD nguyên nhân, | Osteonecrosis of the Femoral Head Carlos J. Lavernia MD Rafael J. Sierra MD and Francisco R. Grieco MD Abstract New cases of osteonecrosis of the femoral head in the United States number between 10 000 and 20 000 per year. This disease usually affects patients in their late 30s and early 40s. Although a number of authors have related specific risk factors to this disease its etiology pathogenesis and treatment remain a source of considerable controversy. This disorder has been associated with corticosteroid use substance abuse and various systemic medical conditions. Either direct damage to osteocytes e.g. by toxin production or indirect damage e.g. due to disorders in fat metabolism or hypoxia may lead to osteonecrosis. Patients at increased risk for osteonecrosis should be monitored closely. Unfortunately most cases are diagnosed in an advanced stage of disease when minimally invasive surgical procedures are no longer helpful. Furthermore patients in the advanced stage of the disease must undergo total hip replacement at a young age which carries a poor long-term prognosis. J Am Acad Orthop Surg 1999 7 250-261 Osteonecrosis of the femoral head is not a specific diagnostic entity but rather the final common pathway of a series of derangements that produce a decrease in blood flow leading to cellular death within the femoral head.1 Necrosis of the femoral head is a progressively debilitating lesion which usually leads to the destruction of the hip joint in patients between 20 and 50 years of age mean age at presentation 38 years .1 In most cases diagnosis is made at advanced stages of the disorder Fig. 1 when femoral head-conserving surgical treatment is no longer indicated.2-4 This condition was first described by Alexander Munro in 1738. Between 1829 and 1842 Jean Cruvilhier described how the femoral head deformed secondary to an interruption in its blood flow. The first detailed description of idiopathic osteonecrosis of the femoral head is attributed to Freund.