Core decompression of femoral head for avascular necrosis
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Avascular necrosis (AVN) most commonly affects the hip joint. It accounts for between 5 and 12% of total hip arthroplasties. This equates to approximately 15,000 new cases in the US each year. The aetiology and pathogenesis are still unclear but a number of risk factors have been identified. These include trauma (intra capsular neck of femur), smoking, corticosteroids, alcohol abuse, haemaglobinopathy, autoimmune disease, Gauchers disease and Caisson disease. Corticosteroids and alcohol account for up to 90% of non traumatic cases.
Several joint preserving techniques have been described. There is little evidence to prove that any single technique has a clear advantage. Core decompression is the most simple and associated with the least morbidity.
The results of all joint preservation techniques for AVN are better for small lesions and early stage disease.
Author:Christopher Edward Bache FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham, UK.
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Question 1 of 10
Which one of the following conditions is not associated with AVN of the femoral head?CorrectIncorrect
Question 2 of 10
Which one of the following statements is true regarding epidemiologyCorrectIncorrect
Question 3 of 10
Which one of the following statements regarding Ficat staging is not true?CorrectIncorrect
Question 4 of 10
Which one of the following techniques has not been described for the management of AVN in the hipCorrectIncorrect
Question 5 of 10
Which one statement is true concerning trap door procedure for AVN?CorrectIncorrect
Question 6 of 10
If a small diameter drill/wire is used which one of the following describes how many passes into the avascular area should be madeCorrectIncorrect
Question 7 of 10
Which one of the following is true regarding patient positioning?CorrectIncorrect
Question 8 of 10
How should the initial incision be made for core decompression of the femur?CorrectIncorrect
Question 9 of 10
Which one of the following is not true regarding location of drill hole in cortex of the femurCorrectIncorrect
Question 10 of 10
Which one of the following is not a recognised complication of this technique?CorrectIncorrect