4/6/2024 0 Comments Xray normal hip latHip preservation is the preferred therapy for young patients. Hip pain and loss of function can affect the quality of life resulting in the need of total hip arthroplasty. Osteonecrosis of the femoral head (ONFH), a devastating disease in young patients, can generally progress to collapse of the femoral head and secondary hip osteoarthritis. Type C1 needs further study to determine which subtype has potential risk of collapse. Besides, JIC type A and type B ONFH can be treated with conservative hip preservation, but pre-collapse type C2 ONFH should be treated with joint-preserving surgery. The collapse can be diagnosed more accurately by combination of AP and FLL views. The collapse rates at five years were reported as 0% and 0%, 16.2% and 24.3%, 58.3% and 68.1% and 100% and 100% according to AP view alone or combination of AP and FLL views for types A, B, C1 and C2, respectively. Seventy-seven (77/89, 86.5%) hips were determined with AP view alone and 85 (85/89, 95.5%) hips were determined with the combination of AP and FLL views. An average follow-up of 37.0 ± 32.0 months was conducted to evaluate the occurrence of collapse in 178 pre-collapse hips. Two hundred and twenty six (226/300, 75.3%) hips and 298 (298/300, 99.3%) hips collapse were identified with AP view and FLL view, respectively. Three hundred cases (300/478, 62.5%) were collapsed at the initial time point. The collapse rates were calculated and compared with Kaplan–Meier survival analysis with radiological collapse as endpoints. All patients with pre-collapse ONFH underwent non-operative hip-preserving therapy. Anterior necrotic lesion was evaluated by FLL view. Japanese Investigation Committee (JIC) classification system was used to classify necrotic lesion in AP view. All patients received standard AP and FLL views of hip joints. Between December 2016 and August 2018, a total of 478 hips from 372 patients with ONFH (268 male, 104 female mean age 37.9 ± 11.4 years) were retrospectively evaluated. The purpose of this study is to assess the efficacy of combined evaluation of anteroposterior (AP) and frog-leg lateral (FLL) view in diagnosing collapse. Total hip replacement. Your doctor will remove both the damaged acetabulum and femoral head, and then position new metal, plastic or ceramic joint surfaces to restore the function of your hip.Load-bearing capacity of the bone structures of anterolateral weight-bearing area plays an important role in the progressive collapse in osteonecrosis of the femoral head (ONFH). Your doctor may recommend surgery if your pain from arthritis causes disability and is not relieved with nonsurgical treatment. Corticosteroids (also known as cortisone) are powerful anti-inflammatory agents that can be taken by mouth or injected into the painful joint.Other NSAIDs are available by prescription. Over-the-counter NSAIDs include naproxen and ibuprofen. Nonsteroidal anti-inflammatory drugs (NSAIDs) may relieve pain and reduce inflammation.Be sure to discuss potential side effects with your doctor. Like all medications, however, over-the-counter pain relievers can cause side effects and interact with other medications you are taking. Acetaminophen (e.g., Tylenol) is an over-the-counter pain reliever that can be effective in reducing mild arthritis pain.If your pain affects your daily routine, or is not relieved by other nonsurgical methods, your doctor may add medication to your treatment plan. Using assistive aids like a long-handled reacher to pick up low-lying things will help you avoid movements that may cause pain. Using walking supports like a cane, crutches, or a walker can improve mobility and independence. Your doctor or physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.Īssistive devices. Specific exercises can help increase range of motion and flexibility, as well as strengthen the muscles in your hip and leg. Losing weight can reduce stress on the hip joint, resulting in less pain and increased function.Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your hip. Minimizing activities that aggravate the condition, such as climbing stairs.Some changes in your daily life can protect your hip joint and slow the progress of osteoarthritis. Your doctor may recommend a range of nonsurgical treatment options. Nonsurgical TreatmentĪs with other arthritic conditions, early treatment of osteoarthritis of the hip is nonsurgical. Although there is no cure for osteoarthritis, there are a number of treatment options that will help relieve pain and improve mobility.
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