Tingart, Markus and Baethis, H. and Perlick, L. and Lerch, K. and Luering, C. and Grifka, Joachim (2004) Treatment of osteonecrosis of the femoral head: Current treatment concepts in Germany. ZEITSCHRIFT FUR ORTHOPADIE UND IHRE GRENZGEBIETE, 142 (5). pp. 553-558. ISSN 0044-3220,
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Aim: The therapy for osteonecrosis (ON) of the femoral head is controversially discussed in the literature. The aim of this study was to ascertain the current treatment concepts of ON in Germany and to compare them with the results reported in the literature. Methods: 219 Departments of Orthopedic Surgery were asked for their treatment strategies in an anonymous country-wide survey regarding the etiology, diagnosis and therapy (conservative, operative) of ON. Univariate analyses were performed and means, medians and rates were calculated. Results: 43% of ON were idiopathic, 28% were due to alcoholism and another 17% were seen after steroid intake. All departments performed biplanar X-rays for diagnosis of ON and 78% of departments obtained additional magnet resonance imaging. In the early stages of ON (stage I, II) 33% of orthopedic clinics recommend a conservative treatment (protected weight bearing, high energy shock wave, pulsed electromagnetic fields) while 67% prefer surgery (79% core decompression, 15% flexion osteotomy, 6% total hip arthroplasty). In the later stages (stage III, IV) most clinics perform an operative treatment (11% core decompression, 10% flexion osteotomy, 79% total hip arthroplasty). Conclusion: Results of ON of the femoral head are unsatisfactory after protected weight bearing. No randomized clinical trials and no mid-term results are available for high energy shock wave or pulsed electromagnetic fields therapy. In the early stages of ON core decompression shows good results. However, in he later stages with secondary arthritis of the hip, total hip arthroplasty remains the gold standard.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BONE-MARROW EDEMA; CORE DECOMPRESSION; AVASCULAR NECROSIS; NONTRAUMATIC OSTEONECROSIS; TRANSIENT OSTEOPOROSIS; INTERTROCHANTERIC OSTEOTOMY; ELECTROMAGNETIC-FIELDS; CONSERVATIVE TREATMENT; SURVIVORSHIP ANALYSIS; HIP; osteonecrosis of the femoral head; conservative treatment; core decompression; total hip arthroplasty |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Orthopädie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Jun 2021 15:26 |
| Last Modified: | 30 Jun 2021 15:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/37313 |
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