Treatment of Osteonecrosis of the Femoral Head. Everything's New

David S. Hungerford

Research output: Contribution to journalArticlepeer-review

Abstract

Since the 1970s, the mantra of those treating osteonecrosis of the femoral head was to save the head at all costs. Total hip arthroplasty (THA), the only effective surgical treatment once the head has mechanically and clinically failed, had a poor track record for young active patients. Recently, THA using highly cross-linked polyethylene, metal-on-metal bearing surfaces, or ceramic-on-ceramic bearing surfaces have given promising results, changing the "save-at-all-costs" paradigm. Operations that have a low success rate, high complication rate or morbidity, or compromise subsequent THA can no longer be justified. This includes femoral osteotomy and free vascularized fibular graft. Core decompression is justified, when indicated, because of its low morbidity and absence of complications with subsequent THA.

Original languageEnglish (US)
Pages (from-to)91-94
Number of pages4
JournalJournal of Arthroplasty
Volume22
Issue number4 SUPPL.
DOIs
StatePublished - Jun 1 2007

Keywords

  • core decompression
  • femoral head
  • femoral osteotomy
  • osteonecrosis
  • total hip arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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