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Orthopedic Surgery Disease:Femoral Head Necrosis Disease

Part of bone tissue become necrotic (No blood flows).

Femoral Head Necrosis Disease is the disease where no blood flows to part of femoral head so that bone necrosis is developed. Part of bone tissue is dead because of no blood flow, but leg or hip joint will not be decayed. Common among relatively young 20’s to 40’s age, and also common for both side necrosis. Basically, it is said that the necroed part will not be extended.

There is a case with no pains.

Pain will not occur with bone necrosis only. Pain will occur when bone necrosis part is crushed flatly. But even with bone necrosis, in case necrosis area is small enough, pain will not occur in entire life period.

Steroid or alcoholic may involve.

Exact cause of femoral head necrosis disease is not yet identified as of today, but history of steroid usage, history of heavy alcoholic user has involved with necrosis development. There is a narrow sense of femoral head necrosis disease with no epidemic risk factor. There is a case where necrosis is developed by embolism related with diving after bone fracture around hip joint.

Aching pain increases when necrosis advances to deformation of joint.

In case necrosis has left as it stand, bone necrosis will occur, then in few months or years later pain will occur. It is said that the pain when loaded is a specific symptom at early stage, yet there is a case disease may get less severe in few weeks period. However, there is a case that a pain may re-appear with further crush of femoral head. In case when bone deformation advances along with femoral head crush, catch on feeling at physical exercise or aching pain may increase. In the long term, damage occur on cartilage and advances to osteoarthritis.

Conservative medical treatment is to be considered for early stage of development.

At medical examination, image inspection like X-ray, MRI and bone scintigraphy inspection are conducted as well as medical interview for symptoms or pre-existing disorder to diagnose femoral head necrosis and to determine necrotic range, then decide follow-on treatment method. Treatment is conducted in accordance with the status of necrotic area, bone crushed condition of femoral head and aching pain condition. In case it is at early stage of development or necrotic area is narrow, there is a case where conservative medical therapy with using analgesic drug or walking stick may be selected. In case necrotic area is broad enough and femoral head crush or aching pain is severe, surgical operation is considered.

Selecting surgical operation depend on the area of necrosis.

As for the conservation method of own femoral head, there is a case where vascular bone transplantation may take place when necrotic range is narrow. When necrotic range is relatively broader case, osteotomy, transfer un-necrotic healthy part to loaded area, may be selected, yet this surgery is relatively complicated, and it is necessary to carefully conduct rehabilitation after surgery.In case necrotic area is broad enough or a case articular symptom has advanced, artificial joint replacement may be taken.

When adequately treated, it is able to live normal daily life with no pains.

Even when femoral head necrosis disease has developed aching pain, painless life can be achieved with having adequate medical treatment so that it is necessary to have medical check and receive an adequate diagnosis. idiopathic necrosis of the femoral head is designated as specified disease by Health, Labor and Welfare Ministry, so that the disease is eligible for medical expense. Consult application with a hospital at the medical inspection.

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