title: High-energy shock wave treatment of femoral head necrosis in adults.
abstract: Adults with Stages I to III osteonecrosis of the femoral head present an overall therapeutic challenge. The objective of the current prospective study was to show the effectiveness of high-energy shock wave therapy in treatment of patients with Association Research Circulation Osseous Stage I to Stage III necrosis of the femoral head by assessing clinical and magnetic resonance imaging results. The current study presents the results of 22 patients with femoral head necrosis 1 year after shock wave treatment. The study population consisted of 10 women and 12 men with an average age of 54.9 years (+/- 12.3). The scores achieved on the visual pain analog scale decreased from 8.5 before treatment to 1.2 after 1 year. Simultaneously, the Harris hip score increased from 43.3 to 92 points. Magnetic resonance imaging visualization of a distinct zone of sclerosis around the necrotic area remaining after treatment with extracorporeal shock wave therapy indicated therapeutic failure. The results obtained so far with high-energy shock wave therapy in these patients suggest that this method may offer an alternative to invasive treatment modalities for femoral head necrosis. A noninvasive and moderately priced method then would be available for the treatment of femoral head necrosis in the early stages of the disease process.
authors.affiliation: Department of Orthopedic Surgery, Ruhr-University Bochum, St Josef-Hospital, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Ludwig
authors.forename: S
authors.initials: S
authors.lastname: Lauber
authors.forename: H J
authors.initials: HJ
authors.lastname: Lauber
authors.forename: U
authors.initials: U
authors.lastname: Dreisilker
authors.forename: R
authors.initials: R
authors.lastname: Raedel
authors.forename: H
authors.initials: H
authors.lastname: Hotzinger
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005271:Femur Head Necrosis / Q000628:therapy*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index