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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 2/2016

01-02-2016 | Orthopaedic Surgery

S3-Guideline non-traumatic adult femoral head necrosis

Authors: A. Roth, J. Beckmann, K. Bohndorf, A. Fischer, C. Heiß, W. Kenn, M. Jäger, U. Maus, U. Nöth, K. M. Peters, C. Rader, S. Reppenhagen, U. Smolenski, M. Tingart, I. Kopp, I. Sirotin, S. J. Breusch

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2016

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Abstract

Introduction

The treatment of adult non-traumatic avascular necrosis of the femoral head (AVN; N-ANFH) within an estimated incidence of 5000–7000 cases per annum in Germany remains a challenge. Risk factors include steroids, alcohol abuse, chemotherapy and immunosuppressive medication, but a genetic predisposition has been suggested. Early diagnosis of this often bilateral disease process is essential for successful conservative or joint preserving surgical management. In this review, we present the update German consensus S3 guideline “diagnosis and management for N-ANFH” as a concise summary.

Materials and methods

This systematic review is based on the published literature from January 1, 1970 to April 31, 2013 (German and English language). Inclusion criteria were systematic reviews, meta-analyses and relevant peer review publications. We identified a total of 3715 related publications, of which 422 were suitable according to the SIGN criteria, but only 159 fulfilled our inclusion criteria.

Results and conclusions

Clinical suspicion of N-ANFH mandates radiographic evaluation. If radiographs are normal MRI scans are recommended, which should be evaluated according to the ARCO-classification. Differential diagnoses include transient osteoporosis, bone bruise, insufficiency fracture and destructive arthropathy. Untreated, subchondral fractures commonly occur within 2 years, during which the risk for contralateral involvement is high—thereafter unlikely. Conservative management with Ilomedin and Alendronat can be tried, but other pharmacological or physical treatments are inappropriate. No specific joint preserving procedure can be recommended, but core decompression should be considered in early stages if necrosis is <30 %. In ARCO stages IIIc or IV total hip arthroplasty (THA) should be contemplated, which offers similar outcome compared to osteoarthritis. Young age is the main risk factor for higher revision rates after THA for N-ANFH.
Literature
1.
Bohndorf K, Beckmann J, Jäger M et al (2015) S3-Leitlinie. Teil 3: atraumatische Femurkopfnekrose des Erwachsenen—Diagnose und Differentialdiagnose. Z Orthop Unfall 153:375–386PubMedCrossRef
2.
Roth A, Beckmann J, Smolenski U et al (2015) S3-Leitlinie. Teil 2: atraumatische Femurkopfnekrose des Erwachsenen—unbehandelter Verlauf und konservative Behandlung. Z Orthop Unfallchir 153:488–497CrossRef
3.
Maus U, Roth A, Tingart M et al (2015) S3-Leitlinie. Teil 3: atraumatische Femurkopfnekrose des Erwachsenen—Operative Therapie der atraumatischen Femurkopfnekrose des Erwachsenen. Z Orthop Unfallchir 153:498–507CrossRef
4.
Beckmann J, Roth A, Niethard C et al (2015) Knochenmarködem und atraumatische Femurkopfnekrose: Therapie. Orthopäde 153:488–497
5.
6.
Scottish Intercollegiate Guidelines Network (SIGN). SIGN 50: a guideline developer’s handbook. Edinburgh: SIGN; 2014. (SIGN publication no. 50). [October 2014]. http://​www.​sign.​ac.​uk. Accessed 15 Sept 2015
7.
Meier R, Kraus TM, Schaeffeler C et al (2014) Bone marrow oedema on MR imaging indicates ARCO stage 3 disease in patients with AVN of the femoral head. Eur Radiol 24:2271–2278PubMedCrossRef
8.
Mitchell DG (1989) Using MR imaging to probe the pathophysiology of osteonecrosis. Radiology 71:25–26CrossRef
9.
Markisz JA, Knowles RJ, Altchek DW et al (1987) Segmental patterns of avascular necrosis of the femoral heads: early detection with MR imaging. Radiology 162:717–720PubMedCrossRef
10.
Beltran J, Burk JM, Herman LJ et al (1987) Avascular necrosis of the femoral head: early MRI detection and radiological correlation. Magn Reson Imaging 5:431–442PubMedCrossRef
11.
Beltran J, Herman LJ, Burk JM et al (1988) Femoral head avascular necrosis: MR imaging with clinical-pathologic and radionuclide correlation. Radiology 166:215–220PubMedCrossRef
12.
Bassett LW, Gold RH, Reicher M et al (1987) Magnetic resonance imaging in the early diagnosis of ischemic necrosis of the femoral head. Preliminary results. Clin Orthop Relat Res 214:237–248PubMed
13.
Robinson HJ Jr, Hartleben PD, Lund G et al (1989) Evaluation of magnetic resonance im aging in the diagnosis of osteonecrosis of the femoral head. Accuracy compared with radiographs, core biopsy, and intraosseous pressure measurements. J Bone Joint Surg Am 71:650–663PubMed
14.
Grimm J, Hopf C, Higer HP (1989) Die Femurkopfnekrose. Diagnostik und morphologische Analyse mittels Röntgen, Szintigraphie, Computertomographie und Magnetresonanztomographie. Z Orthop 127:680–690PubMedCrossRef
15.
Kopecky KK, Braunstein EM, Brandt KD (1991) Apparent avascular necrosis of the hip: appearance and spontaneous resolution of MR findings in renal allograft recipients. Radiology 179:523–527PubMedCrossRef
16.
Fordyce MJ, Solomon L (1993) Early detection of avascular necrosis of the femoral head by MRI. J Bone Joint Surg Br 75:365–367PubMed
17.
Coleman BG, Kressel HY, Dalinka MK, Scheibler ML, Burk DL, Cohen EK (1988) Radiographically negative avascular necrosis: detection with MR imaging. Radiology 168:525–528PubMedCrossRef
18.
Stulberg BN, Bauer TW, Belhobek GH et al (1989) A diagnostic algorithm for osteonecrosis of the femoral head. Clin Orthop Relat Res 249:176–182PubMed
19.
Seiler JG 3rd, Christie MJ, Homra L (1989) Correlation of the findings of magnetic resonance imaging with those of bone biopsy in patients who have stage-I or II ischemic necrosis of the femoral head. J Bone Joint Surg Am 71:28–32PubMed
20.
Talamo G, Angtuaco E, Walker RC et al (2005) Avascular necrosis of femoral and/or humeral heads in multiple myeloma: results of a prospective study of patients treated with dexamethasone-based regimens and high-dose chemotherapy. J Clin Oncol 23:5217–5223PubMedCrossRef
21.
Mont MA, Marulanda GA, Jones LC et al (2006) Systematic analysis of classification systems for osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):16–26PubMedCrossRef
22.
Arlet J, Ficat RP (1964) Forage-biopsie de la tête femorale dans I’osteonecrose primative. Observations histo-pathologiques portant sur huit forages. Rev Rhum 31:257–264
23.
Ficat RP (1985) Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J Bone Joint Surg Br 67:3–9PubMed
24.
Marcus ND, Enneking WF, Massam RA (1973) The silent hip in idiopathic aseptic necrosis. Treatment by bone-grafting. J Bone Joint Surg Am 55:1351–1366PubMed
25.
Steinberg ME, Hayken GD, Steinberg DR (1984) A new method for evaluation and staging of avascular necrosis of the femoral head. In: Arlet J, Ficat RP, Hungerford DS (eds) Bone circulation. Williams and Wilkins, Baltimore, pp 398–403
26.
Steinberg ME, Hayken GD, Steinberg DR (1995) A quantitative system for staging avascular necrosis. J Bone Joint Surg Br 77:34–41PubMed
27.
Ohzono K, Saito M, Takaoka K et al (1991) Natural history of nontraumatic avascular necrosis of the femoral head. J Bone Joint Surg Br 73:68–72PubMed
28.
29.
Zibis AH, Karantanas AH, Roidis NT et al (2007) The role of MR imaging in staging femoral head osteonecrosis. Eur J Radiol 63:3–9PubMedCrossRef
30.
Smith SW, Meyer RA, Connor PM et al (1996) Interobserver reliability and intraobserver reproducibility of the modified Ficat classification system of osteonecrosis of the femoral head. J Bone Joint Surg Am 78:1702–1706PubMed
31.
Schmitt-Sody M, Kirchhoff C, Mayer W et al (2008) Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications. Int Orthop 32:283–287PubMedCentralPubMedCrossRef
32.
33.
Stulberg BN, Levine M, Bauer TW et al (1989) Multimodality approach to osteonecrosis of the femoral head. Clin Orthop Relat Res 240:181–193PubMed
34.
Lee MS, Chang YH, Chao EK et al (2002) Conditions before collapse of the contralateral hip in osteonecrosis of the femoral head. Chang Gung Med J 25:228–237PubMed
35.
Piyakunmala K, Sangkomkamhang T, Chareonchonvanitch K (2009) Is magnetic resonance imaging necessary for normal plain radiography evaluation of contralateral non-traumatic asymptomatic femoral head in high osteonecrosis risk patient. J Med Assoc Thai 92(Suppl 6):147–151
36.
Koo KH, Kim R, Ko GH et al (1995) Preventing collapse in early osteonecrosis of the femoral head. A randomised clinical trial of core decompression. J Bone Joint Surg Br 77:870–874PubMed
37.
Mont MA, Hungerford DS (1995) Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am 77:459–474PubMed
38.
Stulberg BN, Davis AW, Bauer TW et al (1991) Osteonecrosis of the femoral head. A prospective randomized treatment protocol. Clin Orthop Relat Res 268:140–151PubMed
39.
Hungerford DS, Zizic TM (1980) II. The treatment of ischemic necrosis of bone in systemic lupus erythematosus. Med Baltim 59:143–148CrossRef
40.
Malizos KN, Siafakas MS, Fotiadis DI et al (2001) An MRI-based semiautomated volumetric quantification of hip osteonecrosis. Skelet Radiol 30:686–693CrossRef
41.
Ha YC, Jung WH, Kim JR et al (2006) Prediction of collapse in femoral head osteonecrosis: a modified Kerboul method with use of magnetic resonance images. J Bone Joint Surg Am 88:35–40PubMedCrossRef
42.
43.
Ito H, Matsuno T, Kaneda K (1999) Prognosis of early stage avascular necrosis of the femoral head. Clin Orthop Relat Res 358:149–157PubMedCrossRef
44.
Mont MA, Zywiel MG, Marker DR et al (2010) The natural history of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg Am 92:2165–2170PubMedCrossRef
45.
Lieberman JR, Engstrom SM, Meneghini RM et al (2012) Which factors influence preservation of the osteonecrotic femoral head? Clin Orthop Relat Res 470:525–534PubMedCentralPubMedCrossRef
46.
Bassounas AE, Karantanas AH, Fotiadis DI et al (2007) Femoral head osteonecrosis: volumetric MRI assessment and outcome. Eur J Radiol 63:10–15PubMedCrossRef
47.
Liu B, Yi H, Zhang Z et al (2012) Association of hip joint effusion volume with early osteonecrosis of the femoral head. Hip Int 22:179–183PubMedCrossRef
48.
Potter HG, Schachar J (2010) High resolution noncontrast MRI of the hip. J Magn Reson Imaging 31:268–278PubMedCrossRef
49.
Whitehouse R, Bohndorf K (2013) Nekrosen am Skelett. In: Bohndorf K, Imhoff H, Wörtler K (eds) Radiologische Diagnostik der Knochen und Gelenke. Thieme Verlag 3. Auflage
50.
Hofmann S, Kramer J, Plenk H Jr (2002) Die Osteonekrose des Hüftgelenkes im Erwachsenenalter. Radiologe 42:440–450PubMedCrossRef
51.
Mont MA, Ulrich SD, Seyler TM et al (2008) Bone scanning of limited value for diagnosis of symptomatic oligofocal and multifocal osteonecrosis. J Rheumatol 35:1629–1634PubMed
52.
Stevens K, Tao C, Lee SU et al (2003) Subchondral fractures in osteonecrosis of the femoral head: comparison of radiography, CT, and MR imaging. AJR Am J Roentgenol 180:363–368PubMedCrossRef
53.
Reppenhagen S, Kenn W, Reichert J (2007) Bildgebung der aseptischen Femurkopfnekrose des Erwachsenen. Orthopäde 36:436–440CrossRef
54.
Gardeniers JVM (1993) Report of the committee of staging and nomenclature. ARCO news 5:79–82
55.
Turner DA, Templeton AC, Selzer PM et al (1989) Femoral capital osteonecrosis: MR finding of diffuse marrow abnormalities without focal lesions. Radiology 171:135–140PubMedCrossRef
56.
Mitchell MD, Kundel HL, Steinberg ME et al (1986) Avascular necrosis of the hip: comparison of MR, CT, and scintigraphy. AJR Am J Roentgenol 147:67–71PubMedCrossRef
57.
Solomon L (1993) Bone-marrow oedema syndrome. J Bone Joint Surg Br 75:175–176PubMed
58.
Hofmann S, Kramer J, Schneider W et al (1997) Transient osteoporosis may represent a reversible early form of avascular necrosis of the hip joint. Curr Orthop 11:164–172CrossRef
59.
Iida S, Harada Y, Shimizu K et al (2000) Correlation between bone marrow edema and collapse of the femoral head in steroid-induced osteonecrosis. AJR Am J Roentgenol 174:735–743PubMedCrossRef
60.
Kim YM, Oh HC, Kim HJ (2000) The pattern of bone marrow oedema on MRI in osteonecrosis of the femoral head. J Bone Joint Surg Br 82:837–841PubMedCrossRef
61.
Yamamoto T, Kubo T, Hirasawa Y et al (1999) A clinicopathologic study of transient osteoporosis of the hip. Skelet Radiol 28:621–627CrossRef
62.
63.
Bohndorf K (2013) Transiente Osteoporose - transientes Knochenmarködem. In: Bohndorf K, Imhoff H, Wörtler K (eds) Radiologische Diagnostik der Knochen und Gelenke. Thieme Verlag 3. Auflage
64.
Fujioka M, Kubo T, Nakamura F et al (2001) Initial changes of non-traumatic osteonecrosis of femoral head in fat suppression images: bone marrow edema was not found before the appearance of band patterns. Magn Reson Imaging 19:985–991PubMedCrossRef
65.
Vande Berg BE, Malghem JJ et al (1992) Avascular necrosis of the hip: comparison of contrast-enhanced and nonenhanced MR imaging with histologic correlation. Radiology 182:445–450PubMedCrossRef
66.
Kubo T, Yamamoto T, Inoue S et al (2000) Histological findings of bone marrow edema pattern on MRI in osteonecrosis of the femoral head. J Orthop Sci 5:520–523PubMedCrossRef
67.
Ito H, Matsuno T, Minami A (2006) Relationship between bone marrow edema and development of symptoms in patients with osteonecrosis of the femoral head. AJR Am J Roentgenol 186:1761–1770PubMedCrossRef
68.
Radke S, Kenn W, Eulert J (2004) Transient bone marrow edema syndrome progressing to avascular necrosis of the hip—a case report and review of the literature. Clin Rheumatol 23:83–88PubMedCrossRef
69.
Emad Y, Ragab Y, El-Shaarawy N et al (2012) Transient osteoporosis of the hip, complete resolution after treatment with alendronate as observed by MRI description of eight cases and review of the literature. Clin Rheumatol 31:1641–1647PubMedCrossRef
70.
Visuri T (1997) Stress osteopathy of the femoral head—10 military recruits followed for 5–11 years. Acta Orthop Scand 68:138–141PubMedCrossRef
71.
Yamamoto T, Schneider R, Bullough PG (2000) Insufficiency subchondral fracture of the femoral head. Am J Surg Pathol 24:464–468PubMedCrossRef
72.
Davies M, Cassar-Pucillino V, Darby A (2004) Subchondral insufficiency fractures of the femoral head. Eur Radiol 14:201–207PubMedCrossRef
73.
Sugano N, Atsumi T, Ohzono K et al (2002) The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci 7:601–605PubMedCrossRef
74.
Mitrovic DR, Riera H (1992) Synovial, articular cartilage, and bone changes in rapidly destructive arthropathy (osteoarthritis) of the hip. Rheumatol Int 12:17–22PubMed
75.
Watanabe W, Itoi E, Yamada S (2002) Early MRI findings of rapidly destructive coxarthrosis. Skelet Radiol 31:35–38CrossRef
76.
Yamamoto T, Bullough PG (2000) The role of subchondral insufficiency fracture in rapid destruction of the hip joint: a preliminary report. Arthr Rheum 43:2423–2427CrossRef
77.
Yang JH, Oh KJ, Pandher DS (2011) Hydroxyapatite crystal deposition causing rapidly destructive arthropathy of the hip joint. Indian J Orthop 45:569–572PubMedCentralPubMedCrossRef
78.
Ilardi SF, Sokoloff L (1984) Secondary osteonecrosis in osteoarthritis of the femoral head. Hum Pathol 15:79–83PubMedCrossRef
79.
Castro FP, Barrack RL (2000) Core decompression and conservative treatment for avascular necrosis of the femoral head: a meta-analysis. Am J Orthop 29:187–194PubMed
80.
Stulberg BN, Davis AW, Bauer TW et al (1991) Osteonecrosis of the femoral head. A prospective randomized treatment protocol. Clin Orthop Relat Re. 268:140–151
81.
Steinberg ME, Hayken GD, Steinberg DR (1984) The “conservative” management of avascular necrosis of the femoral head. In: Arlet J, Ficat RP, Hungerford DS (eds) Bone circulation. Williams and Wilkins, Baltimore, pp 334–337
82.
Hofmann S, Mazieres B (2000) Osteonekrose: Natürlicher Verlauf und konservative Therapie. Orthopäde 29:403–410PubMed
83.
Tervonen O, Mueller DM, Matteson EL et al (1992) Clinically occult avascular necrosis of the hip: prevalence in an asymptomatic population at risk. Radiology 182:845–847PubMedCrossRef
84.
Neumayr LD, Aguilar C, Earles AN et al (2006) Physical therapy alone compared with core decompression and physical therapy for femoral head osteonecrosis in sickle cell disease. Results of a multicenter study at a mean of three years after treatment. J Bone Joint Surg Am 88:2573–2582PubMedCrossRef
85.
Jäger M, Werner A, Lentrodt S et al (2004) Schmerztherapie bei nichtjuvenilen, aseptischen Osteonekrosen. Schmerz 18:481–491PubMedCrossRef
86.
Tarner IH, Dinser R, Müller-Landner U (2007) Pharmakotherapeutische Aspekte der Femurkopfnekrose. Orthopäde 36:446–450PubMedCrossRef
87.
Disch AC, Matziolis G, Perka C (2005) The management of necrosis-associated and idiopathic bone-marrow oedema of the proximal femur by intravenous iloprost. J Bone Joint Surg Br 87:560–564PubMedCrossRef
88.
Aigner N, Petje G, Schneider W (2005) Bone marrow edema syndrome of the femoral head: treatment with the prostacyclin analogue iloprost vs. core decompression: an MRI-controlled study. Wien Klin Wochenschr 117:130–135PubMedCrossRef
89.
Meizer R, Radda C, Stolz G et al (2005) MRI-controlled analysis of 104 patients with painful bone marrow edema in different joint localizations treated with the prostacyclin analogue iloprost. Wien Klin Wochenschr 117:278–286PubMedCrossRef
90.
Jergesen HE, Khan AS (1997) The natural history of untreated asymptomatic hips inpatients who have non-traumatic osteonecrosis. J Bone Joint Surg Am 79:359–363PubMed
91.
Agarwala S, Jain D, Joshi VR et al (2005) Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study. Rheumatol Oxf 44:352–359CrossRef
92.
Lai KA, Shen WJ, Yang CY (2005) The use of alendronate to prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis. A randomized clinical study. J Bone Joint Surg Am 87:2155–2159PubMedCrossRef
93.
Nishii T, Sugano N, Miki H et al (2006) Does alendronate prevent collapse in osteonecrosis of the femoral head? Clin Orthop Rel Res 443:273–279CrossRef
94.
Agarwala S, Shah S, Joshi VR (2009) The use of alendronate in the treatment of avascular necrosis of the femoral head. J Bone Joint Surg 91-B:1013–1018CrossRef
95.
Kang P, Pei F, Shen B et al (2012) Are the results of multiple drilling and alendronate for osteonecrosis of the femoral head better than those of multiple drilling? A pilot study. Joint Bone Spine 79:67–72PubMedCrossRef
96.
Glueck CJ, Freiberg RA, Sieve L et al (2005) Enoxaparin prevents progression of stages I and II osteonecrosis of the hip. Clin Orthop Relat Res 435:164–170PubMedCrossRef
97.
Nagasawa K, Tada Y, Koarada S et al (2006) Prevention of steroid-induced osteonecrosis of femoral head in systemic lupus erythematosus by anti-coagulant. Lupus. 15:354–357PubMedCrossRef
98.
Ajmal M, Matas AJ, Kuskowski M, Cheng EY et al (2009) Does statin usage reduce the risk of corticosteroid-related osteonecrosis in renal transplant population? Orthop Clin North Am 40:235–239PubMedCentralPubMedCrossRef
99.
Pritchett JW (2001) Statin therapy decreases the risk of osteonecrosis in patients receiving steroids. Clin Orthop Relat Res 386:173–178PubMedCrossRef
100.
Reis ND, Schwartz O, Militianu D et al (2003) Hyperbaric oxygen therapy as a treatment for stage-I avascular necrosis of the femoral head. J Bone Joint Surg Br 85:371–375PubMedCrossRef
101.
Strauss M, Dvozak T (1999) Femoral head necrosis and hyperbaric oxygen therapy. In: Kindwall EP, Whelan HT (eds) Hyperbaric medicine practice. Best publishing practice. pp 909–926
102.
Strauss MB (1995) A “meta-analysis” and economic appraisal of osteonecrosis of the femoral head treated with hyperbaric oxygen. ARCO News 7:110
103.
Ludwig J, Lauber S, Lauber HJ, Dreisilker U, Raedel R, Hotzinger H et al (2001) High-energy shock wave treatment of femoral head necrosis in adults. Clin Orthop Relat Res 387:119–126PubMedCrossRef
104.
Russo S, Galsso O, Gigliotti S (1999) Shock wave therapy for the treatment of nip necrosis. ESMST/2nd Internat. Congress of the European Society for Musculoskeletal Shock Wave Therapy, London (Proceedings)
105.
Wang CJ, Wang FS, Huang CC et al (2005) Treatment for osteonecrosis of the femoral head: comparison of extracorporeal shock waves with core decompression and bone-grafting. J Bone Joint Surg Am 87:2380–2387PubMedCrossRef
106.
Chen JM, Hsu SL, Wong T et al (2008) Functional outcomes of bilateral hip necrosis: total hip arthroplasty versus extracorporeal shockwave. Arch Orthop Trauma Surg 129:837–841CrossRef
107.
Wang CJ, Wang FS, Yang KD et al (2008) Treatment of osteonecrosis of the hip: comparison of extracorporeal shockwave with shockwave and alendronate. Arch Orthop Trauma Surg 128:901–908PubMedCrossRef
108.
Aaron RK, Steinberg ME (1991) Electrical stimulation of osteonecrosis of the femoral head. Semin Arthroplasty 2:214–221PubMed
109.
Bassett CA, Schink-Ascani M, Lewis SM (1989) Effects of pulsed electromagnetic fields on Steinberg ratings of femoral head osteonecrosis. Clin Orthop Relat Res 246:172–185PubMed
110.
Lluch BC, García-Andrade DG, López-Oliva Muñoz F et al (1996) Utilidad de los campos electromagnéticos en el tratamiento de la necrosis avascular de cadera: estudio prospectivo de 30 casas. Rev Clin Esp 2:67–74
111.
Massari L, Fini M, Cadossi R et al (2006) Biophysical stimulation with pulsed electromagnetic fields in osteonecrosis of the femoral head. J Bone Joint Surg Am 88:56–60PubMedCrossRef
112.
Steinberg ME, Brighton CT, Corces A et al (1989) Osteonecrosis of the femoral head. Results of core decompression and grafting with and without electrical stimulation. Clin Orthop Relat Res 249:199–208PubMed
113.
Steinberg ME, Brighton CT, Bands RE et al (1990) Capacitive coupling as an adjunctive treatment for avascular necrosis. Clin Orthop Relat Res 261:11–18PubMed
114.
Aaron RK, Lennox D, Bunce GE et al (1989) The conservative treatment of osteonecrosis of the femoral head. A comparison of core decompression and pulsing electromagnetic fields. Clin Orthop Relat Res 249:209–218PubMed
115.
Im GI, Kim DY, Shin JH et al (2000) Degeneration of the acetabular cartilage in osteonecrosis of the femoral head: histopathologic examination of 15 hips. Acta Orthop Scand 71:28–30PubMedCrossRef
116.
Kawate K, Yajima H, Sugimoto K et al (2007) Indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head. BMC Musculoskelet Disord 8:78PubMedCentralPubMedCrossRef
117.
Berend KR, Gunneson EE, Urbaniak JR (2003) Free vascularized fibular grafting for the treatment of postcollapse osteonecrosis of the femoral head. J Bone Joint Surg Am 85:987–993PubMed
118.
Yoo MC, Kim KI, Hahn CS et al (2008) Long-term followup of vascularized fibular grafting for femoral head necrosis. Clin Orthop Relat Res 466:1133–1140PubMedCentralPubMedCrossRef
119.
Fang T, Zhang EW, Sailes FC et al (2013) Vascularized fibular grafts in patients with avascular necrosis of femoral head: a systematic review and meta-analysis. Arch Orthop Trauma Surg 133:1–10PubMedCrossRef
120.
Schneider W, Breitenseher M, Engel A et al (2000) Der Stellenwert der Bohrung in der Behandlung der Hüftkopfnekrose. Orthopäde 29:420–429PubMed
121.
Beltran J, Knight CT, Zuelzer WA (1990) Core decompression for avascular necrosis of the femoral head: correlation between long-term results and preoperative MR staging. Radiology 175:533–536PubMedCrossRef
122.
Scully SP, Aaron RK, Urbaniak JR (1998) Survival analysis of hips treated with core decompression or vascularized fibular grafting because of avascular necrosis. J Bone Joint Surg Am 80:1270–1275PubMed
123.
Maniwa S, Nishikori T, Furukawa S et al (2000) Evaluation of core decompression for early osteonecrosis of the femoral head. Arch Orthop Trauma Surg 120:241–244PubMedCrossRef
124.
Lavernia CJ, Sierra RJ (2000) Core decompression in atraumatic osteonecrosis of the hip. J Arthroplasty 15:171–178PubMedCrossRef
125.
Saito S, Ohzono K, Ono K (1988) Joint-preserving operations for idiopathic avascular necrosis of the femoral head. Results of core decompression, grafting and osteotomy. J Bone Joint Surg Br 70:78–84PubMed
126.
Mont MA, Carbone JJ, Fairbank AC (1996) Core decompression versus nonoperative management for osteonecrosis of the hip. Clin Orthop Relat Res 324:169–178PubMedCrossRef
127.
Steinberg ME, Brighton CT, Hayken GD (1985) Electrical stimulation in the treatment of osteonecrosis of the femoral head—a 1-year follow-up. Orthop Clin North Am 16:747–756PubMed
128.
Trancik T, Lunceford E, Strum D (1990) The effect of electrical stimulation on osteonecrosis of the femoral head. Clin Orthop Relat Res 256:120–124PubMed
129.
Mont MA, Jones LC, Seyler TM et al (2007) New treatment approaches for osteonecrosis of the femoral head: an overview. Instr Course Lect 56:197–212PubMed
130.
Steinberg ME, Larcom PG, Strafford B (2001) Core decompression with bone grafting for osteonecrosis of the femoral head. Clin Orthop Relat Res 386:71–78PubMedCrossRef
131.
Gangji V, Hauzeur JP, Matos C et al (2004) Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells. A pilot study. J Bone Joint Surg Am 86:1153–1160PubMed
132.
Hernigou P, Beaujean F (2002) Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop Relat Res 405:14–23PubMedCrossRef
133.
Mont MA, Etienne G, Ragland PS (2003) Outcome of nonvascularized bone grafting for osteonecrosis of the femoral head. Clin Orthop Relat Res 417:84–92PubMed
134.
Mont MA, Einhorn TA, Sponseller PD et al (1998) The trapdoor procedure using autogenous cortical and cancellous bone grafts for osteonecrosis of the femoral head. J Bone Joint Surg Br 80:56–62PubMedCrossRef
135.
Kim SY, Kim YG, Kim PT et al (2005) Vascularized compared with nonvascularized fibular grafts for large osteonecrotic lesions of the femoral head. J Bone Joint Surg Am 87:2012–2018PubMedCrossRef
136.
Garberina MJ, Berend KR, Gunneson EE et al (2004) Results of free vascularized fibular grafting for femoral head osteonecrosis in patients with systemic lupus erythematosus. Orthop Clin North Am 35:353–357PubMedCrossRef
137.
Yen CY, Tu YK, Ma CH et al (2006) Osteonecrosis of the femoral head: comparison of clinical results for vascularized iliac and fibula bone grafting. J Reconstr Microsurg 22:21–24PubMedCrossRef
138.
Chen W, Zhang F, Chang SM (2006) Microsurgical fibular flap for treatment of avascular necrosis of the femoral head. J Am Coll Surg 202:324–334PubMedCrossRef
139.
Kane SM, Ward WA, Jordan LC et al (1996) Vascularized fibular grafting compared with core decompression in the treatment of femoral head osteonecrosis. Orthopedics 19:869–872PubMed
140.
Soucacos PN, Beris AE, Malizos K (2001) Treatment of avascular necrosis of the femoral head with vascularized fibular transplant. Clin Orthop Relat Res 386:120–130PubMedCrossRef
141.
Yoo MC, Chung DW, Hahn CS (1992) Free vascularized fibula grafting for the treatment of osteonecrosis of the femoral head. Clin Orthop Relat Res 277:128–138PubMed
142.
Plakseychuk AY, Kim SY, Park BC et al (2003) Vascularized compared with nonvascularized fibular grafting for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am 85-A:589–596PubMed
143.
Urbaniak JR, Coogan PG, Gunneson EB et al (1995) Treatment of osteonecrosis of the femoral head with free vascularized fibular grafting. A long-term follow-up study of one hundred and three hips. J Bone Joint Surg Am 77:681–694PubMed
144.
Eward WC, Rineer CA, Urbaniak JR et al (2012) The vascularized fibular graft in precollapse osteonecrosis: is long-term hip preservation possible? Clin Orthop Relat Res 470:2819–2826PubMedCentralPubMedCrossRef
145.
Meyers MH (1985) Osteonecrosis of the femoral head treated with the muscle pedicle graft. Orthop Clin North Am 16:741–745PubMed
146.
Schneider W, Aigner N, Pinggera O, Knahr K (2002) Intertrochanteric osteotomy for avascular necrosis of the head of the femur. Survival probability of two different methods. J Bone Joint Surg Br 84:817–824PubMedCrossRef
147.
Hasegawa Y, Sakano S, Iwase T et al (2003) Pedicle bone grafting versus transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Bone Joint Surg Br 85:191–198PubMedCrossRef
148.
Shuler MS, Rooks MD, Roberson JR (2007) Porous tantalum implant in early osteonecrosis of the hip: preliminary report on operative, survival, and outcomes results. J Arthroplasty 22:26–31PubMedCrossRef
149.
Tsao AK, Roberson JR, Christie MJ et al (2005) Biomechanical and clinical evaluations of a porous tantalum implant for the treatment of early-stage osteonecrosis. J Bone Joint Surg Am 87(Suppl 2):22–27PubMedCrossRef
150.
Johannson HR, Zywiel MG, Marker DR et al (2011) Osteonecrosis is not a predictor of poor outcomes in primary total hip arthroplasty: a systematic literature review. Int Orthop 35:465–473PubMedCentralPubMedCrossRef
151.
Kawasaki M, Hasegawa Y, Sakano S et al (2005) Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Arthroplasty 20:574–579PubMedCrossRef
152.
Lim SJ, Moon YW, Eun SS et al (2008) Total hip arthroplasty using the S-ROM modular stem after joint-preserving procedures for osteonecrosis of the femoral head. J Arthroplasty 23:495–501PubMedCrossRef
153.
Beckmann J, Rader C, Lüring C et al (2010) Endoprothetische Gelenkersorgung bei Hüftkopfnekrose. Osteologie 19:46–52
154.
Ritter MA, Helphinstine J, Keating EM et al (1997) Total hip arthroplasty in patients with osteonecrosis. The effect of cement techniques. Clin Orthop Relat Res 338:94–99PubMedCrossRef
155.
Davis ET, McKee MD, Waddell JP et al (2006) Total hip arthroplasty following failure of free vascularized fibular graft. J Bone Joint Surg Am 88(Suppl 3):110–115PubMedCrossRef
156.
Radl R, Hungerford M, Materna W et al (2005) Higher failure rate and stem migration of an uncemented femoral component in patients with femoral head osteonecrosis than in patients with osteoarthrosis. Acta Orthop 76:49–55PubMedCrossRef
157.
Mont MA, Seyler TM, Plate JF et al (2006) Uncemented total hip arthroplasty in young adults with osteonecrosis of the femoral head: a comparative study. J Bone Joint Surg Am 88(Suppl 3):104–109PubMedCrossRef
158.
Stulberg BN, Fitts SM, Zadzilka JD et al (2009) Resurfacing arthroplasty for patients with osteonecrosis. Bull NYU Hosp Jt Dis 67:138–141PubMed
159.
Mont MA, Seyler TM, Marker DR, Marulanda GA, Delanois RE et al (2006) Use of metal-on-metal total hip resurfacing for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg Am 88(Suppl 3):90–97PubMedCrossRef
160.
Beaule PE, Amstutz HC, Le Duff M et al (2004) Surface arthroplasty for osteonecrosis of the hip: hemiresurfacing versus metal-on-metal hybrid resurfacing. J Arthroplasty 19(Suppl 3):54–58PubMed
161.
Chan YS, Shih CH (2000) Bipolar versus total hip arthroplasty for hip osteonecrosis in the same patient. Clin Orthop Relat Res 379:169–177PubMedCrossRef
162.
Chiu KH, Shen WY, Ko CK et al (1997) Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. A comparison with other diagnoses. J Arthroplasty 12:683–688PubMedCrossRef
163.
D’Antonio JA, Capello WN, Manley MT et al (1997) Hydroxyapatite coated implants. Total hip arthroplasty in the young patient and patients with avascular necrosis. Clin Orthop Relat Res 344:124–138PubMed
164.
Kim YH, Oh SH, Kim JS et al (2003) Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head. J Bone Joint Surg Am 85-A:675–681PubMed
165.
Ortiguera CJ, Pulliam IT, Cabanela ME et al (1999) Total hip arthroplasty for osteonecrosis: matched-pair analysis of 188 hips with long-term follow-up. J Arthroplasty 14:21–28PubMedCrossRef
Metadata
Title
S3-Guideline non-traumatic adult femoral head necrosis
Authors
A. Roth
J. Beckmann
K. Bohndorf
A. Fischer
C. Heiß
W. Kenn
M. Jäger
U. Maus
U. Nöth
K. M. Peters
C. Rader
S. Reppenhagen
U. Smolenski
M. Tingart
I. Kopp
I. Sirotin
S. J. Breusch
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2375-7

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