Cement supplementation as a treatment for osteonecrosis

Treatment for femoral head osteonecrosis has been less successful in late stages of the disease, after progression to collapse. Several treatment techniques have been reported, however, no single approach has been convincingly successful. Ideally, the goal is to prevent additional collapse and restore femoral head sphericity. Bone grafting techniques predictably halt progression in early stages, but have been less successful at joint restoration once collapse occurs. After collapse, the sphericity of the femoral head may be restored by debriding the necrotic zone then elevating and supporting the collapsed segment by the injection of cement. Cementation is technically simple, ensures the patient immediate postoperative pain relief and improvement in early mobility, and has the potential to restore and maintain the sphericity of the femoral head after collapse. The procedure has low morbidity and does not compromise subsequent revision to total hip arthroplasty. © 2003 Lippincott Williams & Wilkins, Inc.

Duke Scholars

Author Scott Streater Kelley Orthopaedic Surgery