An Overview of Avascular Necrosis of Femoral Head Management

Abstract

Purpose: The aim of this article is to provide an updated review on most commonly used modalities to treat avscular necrosis of femoral head. A thorough literature search was performed using predetermined criteria. Recent Findings: Systematic evaluation for decisions about management demonstrated the following: (1) Though efficacy is vague and controversial non-operative treatments, pharmacological treatments or core decompression can be used in symptomatic medium-sized pre-collapse lesions. (2) In spite of known complications to no vascularized bone graft,vascularized bone grafts and osteotomies -medium to larger-sized lesions can be dealt with them (3) In post-collapse stages, they should be treated with joint preserving techniques, such as hip surfacing, nonvascularized bone graft,vascularized bone grafts (4) If post-collapse and acetabular involvement ensues, arthroplasty is indicated. (5) Cell-based and biological forms of treatment in form of bone marrow aspirate, stem cells, BMP have shown inconclusive results, and further research is needed to assess their role in the management of this condition. Methods: Recent articles were searched on search engines like PubMed, Google Scholar and references of different articles were checked. Summary: There is a need to overview the management options for avascular necrosis of the femoral head. This review discusses different management modalities available along with their advantages and disadvantages. Keywords: AVN femoral head, Non-operative treatment, Biophysical management, Operative treatment