Etiopathogenesis and Modern Treatment of Aseptic Necrosis of the Femoral Head

Abstract

Aseptic necrosis of a femoral head – severe chronic orthopedic pathology (1.2–12 %), diagnostics of which presents considerable difficulties. Problems of fast diagnostics, identical clinical symptoms, rapid development of the disease leads to disability. Risk group includes young and middle-aged men. The cause of the disease is unknown, the possibilities of conservative treatment are applied only in the early stages with doubtful efficiency, and among surgical none is the best. The research is performed in the traumatology center of Khabarovsk – clinical base of a Postgraduate Institute for Public Health Workers. During 2014–2019, retrospective analysis of treatment results was carried out on the basis of statistical data of 97 medical maps of patients diagnosed with aseptic necrosis of a femoral head, pathomorphological study of 49 preparations of the femoral head; laboratory analysis of immunological indicators of cellular immunity and thyroid hormones in the operated group of patients was carried out. Detected immunological changes indicate the systemic nature of the disease. Method of minimally invasive two-stage decompression of femoral neck is devel- oped. Minimum injury of the developed method of treatment provides undeniable advantages in contrast to previous methods of surgical treatment. The technique has been applied in 17 cases, with positive medium-term clinical results. Aseptic necrosis of a femoral head is a pathology with a polymorphologic picture, diagnosis of which presents considerable difficulties, associated with high risk of development at young age, is a current problem and demands further studying for the purpose of achievement of permanent long remission, and, perhaps, and an absolute recovery of the patient.