: Background and Diagnosis Avascular necrosis (AVN), also known as osteonecrosis, atraumatic necrosis or ischemic necrosis, is a debilitating disease that affects a wide range of individuals including children, but is...
: Background and Diagnosis Avascular necrosis (AVN), also known as osteonecrosis, atraumatic necrosis or ischemic necrosis, is a debilitating disease that affects a wide range of individuals including children, but is most common in the middle aged population. AVN of the femoral head (AVNFH) is associated with impaired blood supply to the femoral head resulting in bone necrosis and collapse. It can result from direct damage to the bone (e.g.
Femoral neck fracture), direct injury of the bone or marrow elements (e.g. However, in many patients, the mechanisms in which the disorder develops are not fully understood. There are 20,000 new cases of AVN of the femoral head per year in the United States and accounts for 10% of total hip arthroplasties performed.
We will be covering atraumatic avascular necrosis of the femoral head. AVN of the femoral head is characterized by apoptosis of bone cells (bone marrow, bone forming, and bone destroying cells) that results in bone collapse with a subsequent involvement of the overlying cartilage, provoking flattening of the head surface with, eventually, development of secondary osteoarthritis. The denomination “avascular” is not entirely appropriate as the femoral head blood supplying vessels do not disappear; rather they suffer a pathological process which results in blood flow interruption.
The most common denomination for atraumatic ANFH has been idiopathic, a metabolic disorder background is the most common keystone in every patient. The hepatic metabolism is usually altered either by a primary syndrome, by alcohol intake or by the administration of steroid medication for an immunogenic or autoimmune disease. Other conditions increase the tendency of intravascular coagulation that can be intraosseous or extraosseous.
In cases of trauma, the resulting osteonecrosis is better understood as the vascularity around the femoral head is severely disturbed (mainly medial femoral circumflex artery). The most common etiology for altered metabolism in adults is alcohol intake. This is dose dependent with the relative risk increasing as intake increased, with 9.8 relative risk with 1 liter per week and 17.9 relative risk if more than 1 liter per week.
If you are experiencing symptoms that may be related to avascular necrosis of the femoral head: background, diagnosis and classification, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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