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Aseptic necrosis of the femoral head: causes, symptoms, diagnosis, treatment

From the article you will learn about aseptic necrosis of the femoral head and methods of its treatment.

Aseptic necrosis of the femoral head is a severe disease of the hip joint that causes tissue atrophy in the femoral head bones as a result of abnormal blood circulation in the tissues and complication of the metabolic function in a separate part of the bone.

Aseptic necrosis of the femoral head: causes

This disease affects people of any age category - the disease can be detected both in childhood and in old age. The largest spherical joint in the body is the hip, formed from the femur, the head of the bone and the articular cavity.

If there are no violations, then the head of the femur bone with ligaments is fixed in the hip bone - the acetabulum. In the case of progressive development of necrosis, a gradual change in structure occurs, and the destruction of the bone head. Lack of oxygen supply and nutrients violate the function of cartilage restoration, leading to wear in the area of ​​high loads, and also leads to atrophy of the femoral head.

In the picture

The disease occurs most often with joint damage, from the use of corticosteroids, with the development of pancreatitis, alcoholism, and radioactive exposure. There are certain professions that are at risk because of their job specifics - miners and divers. Sometimes the disease occurs due to genetic changes. There is also idiopathic necrosis - a type of pathology that occurs without obvious motives for the appearance and detection.

Symptoms of malaise with aseptic necrosis of the femoral head

Femoral necrosis is a well-known disease. The lack of a proper diet and lifestyle leads to the beginning of its progression. Modern diagnostic medicine at the moment, is able to recognize the disease at the initial stage - with the aim of preventive further treatment of people at risk.

Soreness
  • The intensity of the manifestation of the disease is determined by its stage. But among the obvious symptoms, the same type is visible: painful sensations, stiffness of the femur during movement, muscle mass in the thigh area decreases, a change in the person’s gait occurs - limping to the problem side.
  • In the absence of treatment, the disease begins to develop rapidly and the symptomatology of the disease increases, the joint changes its shape, which can lead to a loss of freedom of movement, the patient will not be able to walk without a cane or support.
  • It must be understood that with a diagnosis of idiopathic necrosis, treatment only with medical methods will not give a result, but only will stop the progress of the disease. It is important for the patient to undergo more intensive treatment, not to delay timely diagnosis, even with minor symptoms.

Diagnosis of aseptic necrosis of the femoral head

The first diagnosis of the disease occurs in the doctor’s office upon examination of the patient.

  • Most often, the patient resorts to the help of a specialist, with a sufficiently formed stage of the disease. When it becomes impossible to move independently and severe pain attacks become more frequent.
  • The primary form of this disease is almost asymptomatic. But it is important to recognize the pathology until the moment of its extensive development in the body and therefore a more extensive diagnostic study is carried out.
  • The specialist makes a diagnosis based on a study of the history of diseases and palpation in the joint area. For a detailed examination, the patient is recommended to undergo an MRI of the hip joints and fluoroscopy, three-phase scintigraphy to determine oncological pathology in bone and soft tissues, laboratory tests - a thorough study of urine and blood.
MRI

The pathological condition with necrosis has four stages of development:

  1. Initial first stage - pathology may have a hidden course of development. The patient does not suspect the presence of a disease. Violations to a small extent are not able to determine all diagnostic methods. The visual state of the cartilage remains unchanged, but processes of destruction of the spongy substance are already taking place inside - osteonecrosis of the internal tissue of the cartilage is formed.
  2. In the second stage, the patient feels slight discomfort in the pathology zone. There are numerous cracks in the femoral head as a result of an impression fracture.
  3. The third stage is characterized by persistent pain when walking, difficulty moving. At this stage of the disease, cystic formations and seals appear in the head of the bone, the shape of the head becomes uneven - this affects its mobility, the distance between the joints decreases or increases.
  4. At the fourth stage - the disease develops with more severe symptoms: the nature of the pain is ongoing even with complete rest, the joint loses its activity. A total decay of the articular head occurs, distortion or subluxation is formed. There is a shift of the acetabulum along the edges, the distance between the joints decreases to complete disappearance.
Pain during movement

Clinical studies have shown that at each stage of the development of the disease, there is a certain time period before moving to the next stage. So for the first and second stages - the transition time is six months. In the transition from the third to the fourth - this time lasts from 3 to 6 months.

Methods for the treatment of aseptic necrosis of the femoral head

In the case of the establishment of necrosis of an early stage of development, the patient is prescribed conservative methods of treatment:

  • taking painkillers
  • medical gymnastics
  • physiotherapeutic procedures
  • orthopedic techniques
Treatment

Such methods of treatment can stop the course of the disease, but are not effective for the complete healing of the patient. With the advanced stage of necrosis, surgical intervention is required. The patient is prescribed an operation to implant the endoprosthesis - a joint that has become unusable is replaced with a prosthesis.

As a rule, such an operation takes place under the influence of local anesthesia, which allows the patient to recover quickly after prosthetics. The rehabilitation period after surgery is up to six months. At this time, the patient should move with crutches. After the rehabilitation period, the bulk of patients are able to completely restore their active activity.

Watch the video: Avascular Necrosis and Minimally Invasive Treatment Using Stem Cells - Mayo Clinic (October 2019).

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