Femoral head necrosis: the silent killer of the hip joint

Femoral head necrosis, a disease that may sound unfamiliar, is actually quietly threatening the health of the hip joints of countless people and has become a hidden danger that cannot be ignored. It is like a hidden silent killer. The early symptoms are difficult to detect, but it can cause serious damage to joint function and even disability. This article will take you to an in-depth understanding of the medical knowledge of femoral head necrosis, unveil its mystery, help you detect and treat it early, and protect the health of the hip joint.

What is femoral head necrosis?

Femoral head necrosis, also known as avascular necrosis of the femoral head, refers to a disease in which the blood supply to the femoral head is interrupted or damaged due to various reasons, which then causes bone cell death, structural changes and collapse of the femoral head, and ultimately leads to hip pain and limited movement.

What causes femoral head necrosis?

The causes of femoral head necrosis are complex. At present, the medical community generally recognizes that trauma, alcohol, and hormones are the causes of femoral head necrosis. Although there is no evidence-based medical evidence, there are many other factors that are often encountered in clinical practice. In short, the causes of femoral head necrosis are extremely complex and can be roughly divided into two categories: traumatic and non-traumatic:

Traumatic factors: Trauma such as femoral neck fracture, hip dislocation, and acetabulum fracture can directly damage the blood supply to the femoral head and lead to necrosis.

Non-traumatic factors:

Hormone use: Long-term and excessive use of glucocorticoids is one of the most common causes of femoral head necrosis.

Alcoholism: Long-term excessive drinking can affect fat metabolism, leading to blood vessel blockage, and further causing femoral head necrosis.

Others: Diseases such as decompression sickness, sickle cell anemia, and systemic lupus erythematosus may also increase the risk of femoral head necrosis.

What are the clinical symptoms of femoral head necrosis?

The symptoms of femoral head necrosis vary depending on the stage of disease development. Early symptoms are often not obvious and are easily ignored:

Early stage: Mild pain in the groin area or buttocks, which can be relieved by rest and is often mistaken for muscle strain or lumbar disc herniation.

Middle stage: The pain becomes more severe and lasts longer, and symptoms such as lameness and limited joint movement appear.

Late stage: The femoral head collapses, the joint space narrows, and severe pain, lameness, limb shortening, severe limitation of movement, and even loss of ability to walk occur.

How is femoral head necrosis diagnosed?

Early diagnosis and timely treatment are crucial to the prognosis of femoral head necrosis. Commonly used diagnostic methods include:

Physical examination: Specialists rely on their clinical experience and careful physical examination to determine whether there is hip disease by checking the range of motion and tenderness of the hip joint. The diagnosis can be confirmed with the help of imaging.

Imaging examination:

X-ray examination: There may be no obvious abnormalities in the early stage, but changes in femoral head density and collapse may be seen in the middle and late stages.

Magnetic resonance imaging (MRI): It is sensitive to early diagnosis and can detect abnormal signals in the femoral head. Patients with early hip pain are recommended to undergo MRI examination to determine whether there are signs of femoral head necrosis.

CT examination: can show the structural changes of the femoral head more clearly.

What are the treatments for femoral head necrosis?

Regarding treatment, it is highly professional and requires specialists to develop individualized treatment plans based on the patient's age, severity of the disease, cause of the disease and other factors. The specific treatment plans mainly include the following types, and non-professionals only need to have a simple understanding of them.

1. Non-surgical treatment is also commonly known as conservative treatment:

Protective weight-bearing: Use crutches or a walker to take weight off the affected hip.

Drug treatment: Use painkillers, blood-activating and blood-stasis-removing drugs, etc. to relieve symptoms.

Physical therapy: joint range of motion training, muscle strength training, etc.

2. Surgical treatment:

Hip-preserving surgery: Suitable for early-stage patients, aimed at preserving their own femoral head, such as core decompression, bone grafting, etc.

Artificial hip replacement: Suitable for advanced patients, can effectively relieve pain and restore joint function.

How to prevent femoral head necrosis?

It is recommended to avoid prolonged and excessive use of glucocorticoids.

Stop drinking or limit your drinking.

Actively treat the primary disease, such as decompression sickness, sickle cell anemia, etc.

Strengthen hip joint protection and avoid trauma.

Maintaining a healthy lifestyle, including proper weight control and avoiding excessive exertion, is recommended to maintain hip joint health.

Although femoral head necrosis is serious, it is not invincible. By raising awareness of the disease and achieving early detection, early diagnosis, and early treatment, we can effectively delay the progression of the disease, improve the quality of life, and regain health and vitality. If you experience symptoms such as hip pain, please seek medical attention in a timely manner and do not delay, so as not to miss the best time for treatment.

References:

Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association. Expert consensus on the diagnosis and treatment of femoral head necrosis (2015 edition)[J]. Chinese Journal of Orthopaedics, 2015, 35(12): 961-968.

Wang Kunzheng, Wang Yan. Femoral head necrosis[M]. Beijing: People's Medical Publishing House, 2018.

Mont MA, Jones LC, Hungerford D S. Nontraumatic osteonecrosis of the femoral head: ten years later[J]. The Journal of bone and joint surgery. American volume, 2006, 88(5): 1117-1132.

(This article is for reference only. Please consult a professional doctor for specific treatment plans. Pictures are from the Internet. If there is any infringement, please contact us to delete them.)