Nontraumatic Osteonecrosis of the Femoral Head: An Update
Journal of Bone and Joint Surgery, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Basım Tarihi: 2026
- Doi Numarası: 10.2106/jbjs.25.01621
- Dergi Adı: Journal of Bone and Joint Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Public Affairs Index, SportDiscus, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
Nontraumatic osteonecrosis of the femoral head should be suspected in patients who are <50 years of age who have persistent hip pain despite normal radiographs. Bilateral involvement is common; magnetic resonance imaging (MRI) of the contralateral hip is recommended. MRI is the most sensitive modality for detecting early disease. Femoral head sphericity is assessed on anteroposterior, lateral, and 30º view radiographs. Small pre-collapse lesions have the best prognosis. Large lateral lesions and subchondral collapse predict rapid progression. Systemic risk factors and multifocal disease should be actively evaluated. Joint-preserving procedures are most effective before structural collapse. Total hip arthroplasty remains the most reliable treatment after femoral head collapse.