Hip Osteonecrosis


Osteonecrosis is a medical condition that occurs when the blood supply to the spongy bone next to a joint is reduced, causing the bone to stop its biological activity. This loss of activity weakens the bone and can cause it to collapse over time due to the compressive forces acting on the joint. Eventually, this can lead to a degenerative joint disease that may require a prosthetic joint replacement surgery.

Osteonecrosis is commonly associated with steroid medication use and usually affects the hip joint in younger adults. However, joint replacement surgery is often not desirable for younger patients with stage I or II hip osteonecrosis because it is a no-return surgery. In such cases, hip-preserving surgery options are recommended as they can help patients avoid degenerative joint disease and eliminate the need for joint replacement surgery.

When considering hip-preserving surgery, it is important to take into account the volume of necrotic tissue in the femoral head and its relation to the weight-bearing parts of the joint. This information can help determine if hip-preserving surgery will be beneficial for the patient.

The principle of hip-preserving surgery for osteonecrosis of the hip involves drilling a tunnel from the lateral surface of the femur to the head of the femur. The necrotic bone mass is then evacuated and the reamed borehole is filled with bone grafts or alternatives. Traditionally, this procedure is guided by a radioscopy device, which is essentially an X-ray with a screen in the operating room. However, osteonecrosis is generally not easily visible on X-rays, so preoperative CT and MR scans are used to meticulously plan the drilling course.

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The use of stem cell-enriched bone grafts obtained from the patient's own pelvic bone can help support the overlying joint cartilage against early collapse and provide desirable conditions for the necrotic bone to regenerate. This can potentially help patients sustain their lives without progressing into degenerative joint disease and avoid the need for joint replacement surgery.

Please contact us to find out if your condition of osteonecrosis is suitable to be given a chance for "hip preserving surgery" 

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