Rapid resolution of femoral head osteonecrosis after rotational acetabular osteotomy

Abstract

The natural history of osteonecrosis of the femoral head is generally thought to be one of progressive deterioration if no intervention is undertaken. However, it is unknown whether surgical intervention is beneficial for patients with a small region of osteonecrosis. We observed rapid improvement of MRI findings after rotational acetabular osteotomy (RAO) was performed in a young patient with osteonecrosis of the femoral head. The band-like low signal area on T2-weighted images almost resolved by six months after surgery. He returned to work as an electrician by six months after surgery. Early surgical intervention such as RAO that alters the mechanical force acting on the necrotic region of the femoral head may accelerate the recovery of osteonecrosis and the improvement of symptoms.

Contact stress distributions on the femoral head of the emu (Dromaius novaehollandiae)

“…Individual clinical series have reported varying degrees of success with these procedures (e.g. Nozawa et al, 2008; Berend et al, 2003), and there is no consensus as to which treatments work best. This controversy is due, in part, to the lack of ability to systematically compare treatments in an animal model whose natural history is progression to human-like femoral head collapse.…”

Rapid and Severe Idiopathic Aseptic Necrosis of the Contralateral Femoral Head after Unilateral Total Hip Arthroplasty

“…G enerally, it is believed that ONFH will gradually deteriorate naturally if no intervention is taken. 16,17 Some studies have reported that if no intervention is taken after the first discovery of ONFH signs, some cases of ONFH have improved, and some have neither progression nor tendency to improve; however, most of these cases are for asymptomatic or early ONFH. [18][19][20] Therefore, for symptomatic ONFH seriously affecting the normal functional activities of patients, interventions should be carried out in time, among which hip replacement is currently the most effective and common therapeutic option.…”

“…Generally, it is believed that ONFH will gradually deteriorate naturally if no intervention is taken 16,17 . Some studies have reported that if no intervention is taken after the first discovery of ONFH signs, some cases of ONFH have improved, and some have neither progression nor tendency to improve; however, most of these cases are for asymptomatic or early ONFH 18–20 .…”