This article presents the history and development of as well as the results from the various techniques of vascularized bone grafting for the treatment of osteonecrosis (ON) of the femoral head. The authors have treated more than 2600 patients who had femoral head ON, using a vascularized fibular graft by way of an intraosseous approach. The results from this vast experience are summarized and ...

INTRODUCTION: Avascular necrosis of the femoral head (FHN) is a common complication with disabling effect for young patients after high dose corticosteroid treatment [1]. Recently, we could show that steroids have a vasoconstrictive effect on lateral epiphyseal arteries of the femoral head (FH) which could lead to FH ischemia and subsequent necrosis [2]. In the current study we investigated the...

In the treatment of medial fractures of the femoral neck by the Smith-Petersen nail one can distinguish two problems: the first concerns failure to initiate the process of union, as shown by complete separation of the head and the recurrence of the original deformity; the second concerns necrosis and collapse of the femoral head after successful union at the site of the fracture. Complete separ...

The emu, a large bipedal bird with hip joint biomechanics similar to humans, was used to establish an experimental model of femoral head osteonecrosis and subsequent femoral head collapse. Focal lesions were induced in 20 adult male emus using an alternating liquid nitrogen freezing and radiofrequency heating insult. At 2, 4, 8, 12 and 16 weeks post-surgery, hip magnetic resonance imaging (MRI)...

BACKGROUND AND PURPOSE We noticed that our instruments were often too hot to touch after preparing the femoral head for resurfacing, and questioned whether the heat generated could exceed temperatures known to cause osteonecrosis. PATIENTS AND METHODS Using an infra-red thermal imaging camera, we measured real-time femoral head temperatures during femoral head reaming in 35 patients undergoin...

BACKGROUND The optimal treatment of osteonecrosis of the femoral head has not been established yet. The aim of this study was to report preliminary clinical results of focal anatomic-resurfacing implantation for the treatment of osteonecrosis of the femoral head. METHODS Five patients (four male, one female) with seven surgical procedures, ages between 37 and 52 with an average age of 45.2 (+...

This report describes the pathological characterizations of a rare case of necrosis of the femoral head that was spontaneous, bilateral, avascular and nontraumatic. A 14-month-old beagle dog was presented with pain in the hind limbs. At necropsy, the articular surface in the bilateral femoral head was markedly irregular. There were no gross abnormalities other than in the hip joints. Microscopi...

Little is known about the mechanical properties of the growing femoral head as it develops deformity following ischemic injury. The purpose of this study was to determine the indentation stiffness of growing femoral head following ischemic injury and to correlate the changes in stiffness with radiographic and histopathologic changes in the femoral head as it develops deformity. Following the in...

In 12 patients, we measured the oxygen concentration in the femoral head-neck junction during hip resurfacing through the anterolateral approach. This was compared with previous measurements made for the posterior approach. For the anterolateral approach, the oxygen concentration was found to be highly dependent upon the position of the leg, which was adjusted during surgery to provide exposure...

Introduction: The most important factor affecting the outcome of osteosynthesis is not the degree of displacement, but femoral head perfusion after femoral neck fracture. Classifications based on plane radiography including Garden’s classification cannot reflect perfusion of the femoral head. We estimated femoral head perfusion in patients with femoral neck fracture using dynamic magnetic reson...