Aseptic Necrosis of the Femoral Head Associated with Steroid Therapy

Impact of Perioperative Systemic Steroids on Surgical Outcomes in Patients With Chronic Rhinosinusitis With Polyposis: Evaluation With the Novel Perioperative Sinus Endoscopy (POSE) Scoring System

“…The theoretic advantages of perioperative steroids often cited include reduced edema and scarring postoperatively as well as suppression of the intrinsic inflammatory disease to permit better healing and better outcomes. Relevant to this discussion is the fact that systemic steroids have been well described to have a litany of potential side effects, ranging from nuisance short‐term problems such as mood disturbance and fluid retention, to moderate effects such as gastric irritation, to devastating side effects such as osteonecrosis of the femoral head 12 …”

“…Relevant to this discussion is the fact that systemic steroids have been well described to have a litany of potential side effects, ranging from nuisance short-term problems such as mood disturbance and fluid retention, to moderate effects such as gastric irritation, to devastating side effects such as osteonecrosis of the femoral head. 12 Therefore, given that some surgeons advocate the use of perioperative systemic steroids whereas others do not and given that the current evidence on this question is limited and given that there are hundreds of thousands of ESS procedures performed each year and given that systemic steroids have significant potential side effects, it is the primary objective of this study to assess the value of perioperative systemic steroids in patients undergoing ESS for the treatment of CRSwP. The study design developed to assess surgical outcomes is randomized, doubleblind, and placebo-controlled and seeks to assess specific surgical outcomes at the time of surgery as well as subjective and objective outcomes in the short and intermediate postoperative period.…”

Steroid-induced osteonecrosis

“…Since these lesions were not induced by trauma nor supported by infections it was coined ‘aseptic osteonecrosis’. A direct hormonal effect on osteoblasts was hypothesized as the causative mechanism [ 6 ]. With the growing use of systemic glucocorticoids, increased awareness of complications, and improvement of imaging techniques, steroid-induced osteonecrosis was further described in case series and has been later referred to as ‘avascular’ or ‘ischemic necrosis’ [ [7] , [8] , [9] , [10] , [11] ].…”

Study on the outcome of patients with aseptic femoral head necrosis treated with percutaneous multiple small-diameter drilling core decompression: a retrospective cohort study based on magnetic resonance imaging and equivalent sphere model analysis

“…Aseptic necrosis of the femoral head (ANFH), also known as nontraumatic femoral head necrosis, is a pathological process caused by impaired blood supply to the femoral head [1]. This process induces demineralization, trabecular thinning, and subsequent collapse of the joint surface with fracture of subchondral bone [2].…”