[Osteoradionecrosis at the level of coxo-femoral articulation in the adult].
Two cases of either cervical or acetabular osteoradionecrosis were described. One patient had endoprosthetic replacement of the hip, the other did not receive any surgical treatment. Regarding the literature, osteoradionecrosis occurs in 0.3 to 4% of the irradiated bones. Histologically there is a destruction of the bone by direct toxicity of the radiation and by destruction of the vascular supply. The threshold of irreversible bone destruction is 30 Gy. Fractures are epiphenomenons of osseous radionecrosis. The diagnosis can be suspected either by radiographies or by bone scans. Sometimes a bone biopsy is necessary to differentiate between bone necrosis, bone metastasis and eventually a radiation-induced sarcoma of the bone. If the osteoradionecrosis affects the acetabulum, even in the case of a stress fracture without acetabular protrusion of the femoral head, no surgical treatment is recommended. Weight bearing is avoided and spontaneous resolution occurs in most cases. If, on the other hand, there is a fracture through the femoral neck, hemiarthroplasty or total joint replacement is the treatment of choice. Total joint replacement is also recommended in case of an extensive radiation induced coxopathy.
Popowski
G
G
Service de Chirurgie, Institut Jules Bordet, ULB, Bruxelles.
Gebhart
M
M
Benkirane
A
A
Petein
M
M
Van Houtte
P
P
D000077:Acetabulum / Q000528:radiation effects* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005272:Femur Neck / Q000528:radiation effects* / Q000601:surgery; D005598:Fractures, Spontaneous / Q000209:etiology; D006620:Hip Fractures / Q000209:etiology; D006622:Hip Prosthesis; D006801:Humans; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011859:Radiography
Radionécrose au niveau de l'articulation coxofémorale chez l'adulte.