Author/Editor		Dolinar, Drago
Title		Aseptična nekroza glavice stegnenice pri odraslih
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1998
Volume		str. 85
Language		slo
Abstract		We studied some basic characteristics of nontraumatic avascular necrosis of the femoral head, and evaluated the long-term results of operative treatment of this disease in 135 adult patients (183 hips). There was a male sex preponderance, i.e. 31 women versus 104 men. The disease affected mostly the age group of 30 to 50 years (average age 40.3 yrs, SD +- 9 yrs). In about one third of cases both hips were affected. The major specific causes of bone necrosis included alcoholism in 55 patients (41 percent) and steroid therapy for systemic lupus erythematosus, rheumatoid arthritis and renal transplantation in 19 patients (14 percent); in 47 patients (35 percent), the disease was considered to be of idiopathic orgin. The rare specific causes of bone necrosis included diabetes, hyperlipidaemia, cigarette smoking, pregnancy, radiation and vascular disease in 14 patients (10 percent). The form of treatment was selected according to the stage of radiologic involvement (Ficat and Arlet) and malignancy. We performed 22 core decompressions, 54 intertrochanteric osteotomies, 24 transfers of vascularised pedicle iliac bone grafts, 62 total hip replacements and 1 arthrodesis. Clinical results were evaluated by the modified Harris Hip Score and Survival curve analysis. In the group treated by core decompression (2 Stage I and 14 Stage II patients, the rest with advanced stages of the disease), 18% of clinical results were excellent, 23% good, 14% fair 41% poor and 4% were not precisely evaluated. In the intertrochanteric osteotomy group (19 Stage Ii and 33 Stage III patients), clinical results were excellent in 17% of cases, good in 27%, fair in 13%, poor in 16% and in 26% of cases were not precisely evaluated.(Abstract truncated at 2000 characters)
Descriptors		FEMUR HEAD NECROSIS ADULT OSTEOTOMY BONE TRANSPLANTATION ALCOHOLISM ADRENAL CORTEX HORMONES KIDNEY FAILURE HYPERLIPIDEMIA HIP PROSTHESIS TREATMENT OUTCOME