title: The physiopathology of avascular necrosis of the femoral head: an update.
abstract: The physiopathology of the femoral head bone necrosis is similar for children and for adults. The disease is characterized by apoptosis of bone cells - bone marrow and bone forming cells-resulting in head collapse with a subsequent lesion of the overlying cartilage, and therefore flattening of the rounded surface shape of the head articulating with the acetabulum, provoking, eventually, secondary osteoarthritis. When the disease becomes clinically evident already destructive phenomena have occurred and collapse will eventually ensue. In children, because epiphyseal cartilage has growth capabilities, lost epiphyseal height can be recovered, however in adults collapse is irreversible. In this paper the physiopathology of this disease is examined as well as its implication for treatment. Prevention by genetic studies is discussed.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol. University of Malaga, Spain. Electronic address: eguerado@hcs.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: Guerado
authors.affiliation: Research Unit, Hospital Universitario Costa del Sol. University of Malaga, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Caso
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D000818:Animals; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology*; D050723:Fractures, Bone / Q000503:physiopathology*; D020022:Genetic Predisposition to Disease; D006132:Growth Plate / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007511:Ischemia / Q000473:pathology; D010027:Osteotomy / Q000379:methods; D011859:Radiography
keywords: Avascular necrosis; Bone necrosis; Cartilage disruption; Femoral head; Genomics; Growth cartilage; Hip Fracture; Perthes’ Disease