Hip Osteonecrosis

Description

Professor Dominic Meek gives his expert insights and discusses the case of a 35-year-old man suffering from progressive hip pain for three months, diagnosed with osteonecrosis following an MRI that revealed edema and sclerosis in the bone but no cortical collapse. The management approach emphasizes core decompression as a primary treatment, highlighting that more aggressive bone grafting and the use of growth factors may lead to better outcomes than simple decompression. It also notes that bisphosphonates can serve as an auxiliary treatment in these cases. Additionally, Professor Meek mentions that non-weight bearing therapy alone is not effective, and that hip resurfacing is contraindicated in active osteonecrosis situations to prevent rapid conversion to total hip replacement. Total hip replacement should only be considered if non-invasive treatments fail, with a noted 30% risk of requiring eventual hip replacement regardless of the initial intervention.


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DOI: 10.1302/3114-251271

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