Orthopedic & Muscular System: Current Research
Open Access
ISSN: 2161-0533
+44-20-4587-4809
ISSN: 2161-0533
+44-20-4587-4809
Noshpal Todor
Accepted Abstracts: Orthop Muscul Syst
A vascular femoral head necrosis (AFHN) is common orthopaedic problem that usually ends with invalidity of the patient, followed with social and economical problems. The solution of this medical problem recommends some surgical procedures, which depend on the stage of the disease. The variety of operations can be done ranging from simple core decompression, across osteotomy by itself or combined with core decompression, up to total hip replacement (THR). The type of choosing the surgical procedure usually depends on the degree of damage of the femoral head. At our hospital we usually use Ficat staging for AFHN. For stage 0 and 1, we recommend simple core decompression, for 2 and 3 core decompression or THR and for stage 4 THR. From 01.1989 to 01.2009 at our Hospital for Orthopaedic Surgery we have treated 549 patients (mean age 52), who have suffered from AFHN. The diagnosis for the disease was established by X-ray, photo scan with Tc99m, and MRI. During that period 419 male (34 bilateral) and 130 female patients (13 bilateral), were operated at our hospital according to the principles mentioned above. In 67 (45 male and 22 female) of them we couldn?t find the ethyology of AFHN, in 75 (45 male and 30 female) after dialysis or kidney transplant, 192 (114 male and 78 female) were posttraumatic, 116 (all male) with anamnesis of excessive use of alcohol, 84 (36 male and 48 female) in patients with anamnesis of excessive use of steroids because of other diseases, and 15 patients after irradiation. In 226 (146 male and 80 female) patients, who were in stage 0 or 1 by Ficat, we performed simple core decompression; 46 (25 male and 21 female) patients in stage 1-2 we have treated with core decompression and osteothomy, 120 patients (75 male and 45 female), were treated with THR and 13 patients (2 male and 1 female) who were in stage 3 with good acetabulum were treated with STHR. 144 (102 male and 42 female) patients were re operated with THR, after decompression According to our experience AFHN as a common problem in orthopaedic practice can be treated successfully by minor surgical procedures if it is detected in early stage of the disease. In that way we can avoid invalidity and major surgical procedures, like THR. But sometimes even in those cases were we have made everything to save the hip, the disease can carry on with its progress and destroy the hip. In such cases we can?t avoid THR, often in very young patients