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Osteonecrosis of the Femoral Head

When the blood supply to the femoral head is disrupted, avascular necrosis ensues. The hard strong femoral head soften and collapse from the weight bearing.

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When talking about hip osteoarthritis, many think it is a disease of the elderly. As a matter of fact, hip osteoarthritis can also occur in young people. One of the common causes is osteonecrosis or avascular necrosis of the femoral head, the death of bone tissue due to lack of blood supply.

Hip joint consists of articulation between ball-shape femoral head and complimentary socket-shape contact point on the pelvic bone and function in the transfer of body weight to both legs when we are standing upright.

When the blood supply to the femoral head is disrupted, avascular necrosis ensues. The hard strong femoral head soften and collapse from the weight bearing. The smooth articular surface of the femoral head become roughened leading to hip osteoarthritis.

Risk factors

  • Long-term use of alcohol or steroids
  • Hip dislocation or fracture
  • Blood disorders or certain types of autoimmune diseases

Symptoms
Groin pain which may radiate to the front of thigh and knee. Motions of the hip joint bring on the pain or catching sensation. If the condition aggravates, you may have difficulty walking or start to limp. Femoral head subsidence can lead to leg length discrepancy.

Diagnosis
Your doctor will ask about your medical condition, perform a physical exam, and order X-ray of both hip joints. In some cases, MRI may be required because early-stage disease may not be detectable by regular X-ray imaging.

Treatment
Treatment approach depends on the stages of the disease. In the early, non-collapse stages with no osteoarthritis, treatment goal is to slow down disease progression and conserve the natural hip joint as long as possible. Treatments include pain relievers, assistive walking devices, physical therapy to relieve pain and strengthen hip muscles, or hip core decompression to relieve pressure in the femoral head.

Early detection is paramount to delay the need for hip joint replacement.

If the disease has progressed to the stage of femoral head collapse or hip osteoarthritis, hip joint replacement is recommended to take away the pain and enable quick resumption of normal hip functions.

Article by

Published: 07 Sep 2021

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