| Abstract [eng] |
Background. Avascular necrosis of the femoral head is characterized by diminished blood flow to the femur's head, which leads to osteonecrosis, and results in the eventual structural collapse of the femoroacetabular joint. Changes in blood supply can arise due to a traumatic incident or stem from a non-traumatic origin (corticosteroids usage; alcohol consumption). To date, there is no consensus on treatment, and existing methods are controversial. Aim: Review the literature on femoral head avascular necrosis and present its etiopathogenesis, diagnostic and treatment options. Methods. A literature review was performed on PubMed using the keywords “avascular necrosis,” “femoral head,” and “osteonecrosis,” focusing on articles published in the last 12 years, excluding non-English and those centered solely on surgical treatments. Results. Fractures of femur and hip dislocations are the most frequent traumatic causes of avascular necrosis. Cortisone-like drugs and excessive spiritis consumption were traditionally viewed as the primary contributing factors for emerging avascular necrosis. Recent studies emphasize impaired angiogenesis, coagulopathy and endothelial dysfunction as significant risk factors. Magnetic resonance imaging remains the gold standard for diagnosis, while nuclear diagnostic methods are used for predicting prognosis. Biphosphonates, statins, vasodilators prove to be effective but remain to be prescribed without guidelines. For patients with early disease, it is commanly recommended to do decompression of femoral head core. Conclusions. Impaired angiogenesis, coagulopathy and endothelial dysfunction are identified as predisposing factors for AVN. Pharmacotherapy and core decompression are effective therapies for low stage disease. |
