Rapid resolution of femoral head osteonecrosis after rotational acetabular osteotomy

Masahiko Nozawa,Haruka Kaneko,Takashi Ikegami,Reiko Kubota,Keiji Matsuda,Masataka Nagayama,Kouichi Maeda,Sungon Kim,Kentaro Hayashi,Katsuhiko Maezawa

doi:10.1007/s10195-008-0032-4

Masahiko Nozawa, Haruka Kaneko + Show 8 more

Open Access

https://doi.org/10.1007/s10195-008-0032-4

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Abstract

The natural history of osteonecrosis of the femoral head is generally thought to be one of progressive deterioration if no intervention is undertaken. However, it is unknown whether surgical intervention is beneficial for patients with a small region of osteonecrosis. We observed rapid improvement of MRI findings after rotational acetabular osteotomy (RAO) was performed in a young patient with osteonecrosis of the femoral head. The band-like low signal area on T2-weighted images almost resolved by six months after surgery. He returned to work as an electrician by six months after surgery. Early surgical intervention such as RAO that alters the mechanical force acting on the necrotic region of the femoral head may accelerate the recovery of osteonecrosis and the improvement of symptoms.

Highlights

Joint-preserving procedures for the treatment of osteonecrosis of the femoral head in young patients include core decompression, vascularized bone grafting, and proximal femoral osteotomy
The natural history of osteonecrosis of the femoral head is generally thought to be one of progressive deterioration if no intervention is undertaken. It is unknown whether surgical intervention is beneficial for patients with a small region of osteonecrosis
There is controversy about whether or not the presence of asymptomatic disease is an indication for a joint-preserving procedure

Summary

Introduction

Keywords Osteonecrosis of the femoral head Á MRI finding Á Rotational acetabular osteotomy Introduction Joint-preserving procedures for the treatment of osteonecrosis of the femoral head in young patients include core decompression, vascularized bone grafting, and proximal femoral osteotomy. We observed interesting MRI changes in a 39-yearold man with osteonecrosis of the femoral head at six months after RAO, which are reported here.

Results

Conclusion