Osteonecrosis of the Hip: Management in the Twenty-first Century by Jay R. Lieberman, Daniel J. Berry, Michael A. Montv, Roy K. Aaron, John J. Callaghan,

Osteonecrosis of the Hip: Management in the Twenty-first Century

by Jay R. Lieberman, Daniel J. Berry, Michael A. Montv, Roy K. Aaron, John J. Callaghan, Amar Rayadhyaksha, and James R. Urbaniak

J Bone Joint Surg AmVolume 84(5):834-853

May 1, 2002

©2002 by The Journal of Bone and Joint Surgery, Inc.

A concept of pathogenesis of osteonecrosis that unifies several hypotheses.

Jay R. Lieberman et al. J Bone Joint Surg Am 2002;84:834-853


A lateral radiograph of the hip, demonstrating the crescent sign.



Fig. 3-A T1-weighted magnetic resonance image demonstrating a small osteonecrotic lesion on the right, a large lesion on the left, and loss of signal intensity beyond the lesion on the left.



T1-weighted magnetic resonance image with low-intensity signal representing bone marrow edema in the femoral head, neck, and metaphysis consistent with transient osteopenia of bone.



The fibular graft with the peroneal vessels is harvested from the ipsilateral calf for insertion into the core in the femoral neck and head.



Cancellous bone harvested from the greater trochanteric area is inserted into the cavity formed by removal of the necrotic bone.



Figs. 7-A, 7-B, and 7-C Anteroposterior radiographs of the right hip of a thirty-year-old woman who had Ficat Stage-III osteonecrosis of the femoral head.



Schematic diagram demonstrating the cortical window at the femoral head-neck junction.



Preoperative anteroposterior radiograph of the left hip joint, showing collapse of the femoral head with an intact joint space.



Anteroposterior radiograph of the same hip joint three years after limited femoral resurfacing.



Anteroposterior radiograph of a failed vascularized fibular graft used for treatment of osteonecrosis of the femoral head.



Anteroposterior radiograph made after conversion to a cementless total hip arthroplasty.



Documents

Osteonecrosis of the Hip: Management in the Twenty-first Century by Jay R. Lieberman, Daniel J. Berry, Michael A. Montv, Roy K. Aaron, John J. Callaghan,