The Clinical Center of Friedrichshafen specializes in surgical treatment of hip joint diseases, one of them being necrosis of femoral head. According to statistic, every third person suffering from severe hip joint pain due to the third stage of osteoarthritis needs the surgical treatment of the femoral head. A hip joint, as it is known, is the most massive spherical joint in our body that consists of two key elements: the acetabulum, which is located at the junction of three hip bones and the femoral head. And the blood to the latter is carried by one artery running through the femoral neck. Such supply from a single vascular reservoir is a prerequisite for a certain kind of problems, as blood flow disturbance due to some exo- or endogenic damages eventually leads to the necrosis (i.e. sphacelation) of a bone tissue and other negative consequences.
The blood supply disturbance as a result of thrombosis or arterial trauma, systemic or inflammatory diseases, ingestion of certain drugs and so on, causes a pathological deficiency of oxygen and important nutrients in tissues, coagulation and denaturation of cytoplasmic proteins, retardation and thereafter cessation of the reparative processes, disintegration of the cell and its organelles, and eventually, to the local avascular necrosis.
Clinically the impairment of the mechanical characteristics of tissues and joint dysfunction result in severe pains. Although, in practice, frequently, the disease progresses over a long period of time and when, for example, its cause is an injury previously sustained, the patient may feel first symptoms only in a year or two after it.
First, a person feels pain in the hip joint area at the moment of the excursion of the body center of gravity onto the injured joint, and later it spreads over the groin and buttocks area. Further, the disease develops into a significant reduction of the joint mobility that causes lameness and in the neglected cases the person feels pain in a state of immobility.
The experts identify four stages of the femoral head necrosis. The first one is marked by insignificant changes in the bone structure (to a maximum of 10%), lack of mobility problems, transient and episodic pains that can sometimes radiate to the groin area.
At the second stage a fracture in the femoral head appear (affection is already 10-30%) and pains become permanent; at the third stage the process involves the acetabulum (tissue damage is from 30 to 50%), the mobility of the joint significantly reduces, pains are not only continuous, but severe. The fourth stage of the femoral head necrosis, in addition to all above, is specified by the femoral head destruction, atrophy of the femoral muscles and the muscles of the buttocks area, as well as the least mobility of the joint.
The diagnostics of the necrosis of the femoral head is primarily built upon the results of X-ray examination or nuclear magnetic resonance imaging that makes it possible to detect the smallest deformity in the bone structure. Namely on the basis of the data, received from the above mentioned examinations, highly qualified doctors of Friedrichshafen clinic work out care regimen for each patient individually.
Orthopaedics in Germany has achieved excellent results in treatment of this disorder. Regarding treatment, the keystone to success here is the correct selection of the optimal method of surgical intervention with due consideration of the stage of the disease, the patient's overall health and other important factors.
In fact, the operations, performed in case of the avascular necrosis of the femoral head, should ensure the qualitative decompression of the focus of the necrosis, they involve the implantation of the vascularized musculoskeletal fragment into the femoral head and neck, these can also be different variants of osteotomies of the femoral bone and the replacement (arthroplasty) of the hip joint. By the way, the arthroplasty is the most efficient and effective method of treating the fourth stage of the necrosis of the femoral head.
The operation is the only way to relieve the condition of the patient suffering from the avascular necrosis of the femoral head. Today, there are several types of operations that are carried out in the event of this disease:
The first three types are used only at the early stages of the disease when the main patient's complaint is pain in the hip joint. The X-ray of these patients shows minimal changes or none. Only nuclear magnetic resonance imaging detects the locus of the necrosis.
These kinds of operations usually have a positive effect, but its efficacy and duration can vary significantly.
The total hip joint arthroplasty may be used at any stage of the avascular necrosis. It should be noted that in recent years the technology of the hip joint arthroplasty has been significantly improved. New models of implants, which fit well even young patients, have appeared. Therefore, nowadays, when choosing surgery, the patients suffering from the avascular necrosis of the femoral head almost universally prefer the hip joint arthroplasty. Call us for more information about necrosis of the femoral head treatment.
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