Science Letters

Treatment of Early Osteonecrosis of Femoral Head: A Review of Femoral Head Sparing Procedures

Mohammadhussain Mohammedsalim Lapia #, Zhefeng Chen #, Feng Liu, Sohail Ahmed, Weimin Fan*

Department of Orthopedics, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China

Abstract

Osteonecrosis (ON) is a complex disorder most commonly affecting the weight bearing joints, primarily the hip. To understand the choice of treatment in osteonecrosis, it is important to have knowledge about the classification of the lesions of osteonecrosis. The widely accepted classification systems for osteonecrosis are Steinberg classification, Ficat and Arlet classification and Association Research Circulation Osseous (ARCO) classification. However, considering the lack of level 1evidence and proportionately lesser prospective studies conducted, it is difficult to delineate an optimal therapeutic opinion for each stage of osteonecrosis. This review describes the summary of different femoral head sparing procedures along with their descriptions, advantages and disadvantages and their percent success rate. It can be said that femoral head sparing procedures is a decent modality to delay replacing procedures in precollapse stages. The core decompression alone has not been able to produce favorable results in all the stages of osteonecrosis. Thereby adjunctive options have been discovered, which have resulted in favorable clinical outcomes. With more rigorous prospective study, we will be able to come up with more possible favorable methods of treatment of osteonecrosis.

Keywords: Biological agents, bone grafting, femoral head, implants, osteonecrosis.

Received October 09, 2015 Accepted December 15, 2015 Abstract Published January 15, 2015 Manuscript Published April 15, 2016

*Corresponding author: Weimin Fan Email: fanweimin@vip.sina.com Tel: +86 25 83718836 Fax: +86 25 83724440

#These authors contributed equally to the work.