J Korean Hip Soc.  2011 Mar;23(1):7-14. 10.5371/jkhs.2011.23.1.7.

Joint Preserving Operations for Femoral Head Osteonecrosis

Affiliations
  • 1Department of Orthopaedic Surgery, Pohang St. Mary's Hospital, Pohang, Korea.
  • 2Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. khkoo@snu.ac.kr
  • 3Department of Orthopaedic Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.

Abstract

Osteonecrosis of the femoral head mainly occurs in young patients, and the hip joint with osteonecrosis of the femoral head can be preserved by adequate joint-preserving surgery. This review article includes the information, surgical technique, pitfalls and results of several types of joint preserving surgeries.

Keyword

Femoral head; Osteonecrosis; Joint preserving; Surgical treatment

MeSH Terms

Head
Hip Joint
Humans
Joints
Osteonecrosis

Figure

  • Fig. 1 A 34-year old male patient who underwent nonvascularized fibular graft. (A) Preoperative anteroposterior radiograph. (B) T1-weighted coronal MR image. (C) Anteroposterior radiograph and (D) lateral radiograph at postoperative 4 years show slight collapse of the femoral head.

  • Fig. 2 A 38-year old male patient who underwent vascularized fibular graft. (A) Preoperative anteroposterior radiograph. (B) T1-weighted coronal MR image. (C) Anteroposterior radiograph and (D) lateral radiograph at postoperative 4 years show slight collapse of the femoral head.

  • Fig. 3 A 20-year old male patient who underwent transtrochanteric rotational osteotomy. (A) Anteroposterior radiograph and (B) frog leg view show slight collapse of the femoral head. (C) The necrotic zone is located in the anterosuperior aspect of the femoral head on the T1-weighted midsagittal MR image. (D) The proximal segment was rotated anteriorly with a rotational angle of 90°.

  • Fig. 4 A 19-year old male patient who underwent curved intertrochanteric varus osteotomy. (A) Anteroposterior radiograph shows slight collapse of the femoral head. (B) The necrotic zone is located in the medial aspect of the femoral head on the T1-weighted midcoronal MR image. (C) Anteroposterior radiograph immediately after curved intertrochanteric varus osteotomy. (D) Anteroposterior radiograph at postoperative 3 years.


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