Osteonecrosis of the Femur - Hip Resurfacing Surgery, Alternatives to Hip Replacement

Osteonecrosis is a condition due arising from aTreatment is by a total hip replacement if bony
diminution of blood supply to bone. It affects mostdestruction is extensive. A partial or total surface hip
importantly the upper end of the femur. If leftreplacement is done if destruction is confined to the
untreated it progresses to bony collapse and arthritis.surface cartilage alone. Since it occurs in young
The causes are many like alcohol abuse, steroidindividuals, a Surface Hip replacement is a better
intake, Caisson's disease, Gaucher's disease.option as it conserves bony stock and a total hip
The patient can experience sudden pain in the hipsreplacement can still be done at a later date.
which radiates to the knee and can be confused forResurfacing of the hip is restricted to those cases of
knee pain. Gait is painful. In early cases, x- rays areosteo necrosis where the amount of destruction is
negative and MR scans are diagnostic. Treatment inless than 30 percent of the head.
the early stages is controversial and there are noWhere it exceeds thirty percent, a new type of hip
clear guidelines.prosthesis called the Proxima hip is available in
Prolonged bed rest and crutch walking have not beenChennai.
shown to relieve pain or halt progression of theThis Proxima hip is an uncemented metal on metal
disease.large diameter bearing. It has been performed for
Treatment in late casesavascular necrosis and other conditions like ankylosing
Core decompression does ameliorate symptoms. It isspondylitis, post traumatic arthritis following acetabular
minimally invasive and does not involve a replacement.fracture.
If it fails then a replacement is possible at a laterVascularised fiblar graft is done with the help of a
date.microvascular surgeon.
Treatment in late cases with advanced destruction