title: Alcohol-induced multifocal osteonecrosis: a case report with 14-year follow-up.
abstract: Alcohol-induced osteonecrosis of femoral head is common but multifocal osteonecrosis secondary to alcohol is very rare. The authors report one case of multifocal alcohol-induced osteonecrosis involving both hips and both knees and its subsequent progression and management over a period of 14 years. There was bilateral involvement of hips in pre-collapse stage for which a core decompression was done. The left hip responded well and at 14-year follow-up was asymptomatic with full range of motion. The core decompression surgery failed in the right hip within 1 year and subsequently hybrid total hip replacement arthroplasty was done with good functional results at 13 years follow-up. The diagnosis of knee osteonecrosis was most probably missed initially and was subsequently diagnosed 6 months back due to symptoms of pain and radiographic findings for which a core decompression was done with good early results. The results of treatment of hip was excellent in our patient and despite the rarity, a high degree of suspicion and regular screening is necessary to detect involvement of other areas like the knee in alcohol-induced osteonecrosis.
authors.affiliation: Department of Orthopedic Surgery, Korea University Guro Hospital, Guro-gu, Seoul, South Korea.
authors.forename: Jun Gyu
authors.initials: JG
authors.lastname: Moon
authors.forename: Gautam M
authors.initials: GM
authors.lastname: Shetty
authors.forename: Sandeep
authors.initials: S
authors.lastname: Biswal
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Shyam
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Shon
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000150:complications*; D019644:Arthroplasty, Replacement, Hip; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007719:Knee Joint; D008297:Male; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011859:Radiography