Due to the influence of various factors, the destruction of the pelvic tissue and the femoral head and bone occurs. It is accompanied by degenerative-dystrophic processes, in which osteophytes (outgrowths) are formed and arthrosis develops. This disease, aseptic necrosis of the head of the femur, in accordance with the stage of tissue death, can lead to serious consequences, up to disability.
Causes of aseptic necrosis of the head of the left or right femur
The described degenerative pathology of bone tissue develops when a combination of several factors are listed below:
- reception of corticosteroids ;
- mechanical injuries of the hip joint;
- violation of the exchange processes;
- exposure to ionizing radiation;
- alcohol abuse;
- sickle-cell anemia;
- pancreatitis;
- bone disease;
- constant overload of the hip joint;
- diseases of the vascular system.
If you can not determine the cause of the ailment, it is considered idiopathic.
Symptoms of aseptic necrosis of the femoral head
The main signs of the disease:
- atrophy of soft tissues and hip muscles;
- pain syndrome;
- transfer most of the load to a healthy leg;
- decreased mobility of the joint.
Also, the course of aseptic necrosis of the head of the femur depends on its stage, there are only four of them:
- At the first stages of the progression of the disease a person feels quite intense pain, which appears with physical exertion and can give back to the groin. At the same time, the normal amplitude of movements in the joint remains, the body weight is distributed evenly on both legs.
- The second stage is characterized by an intensification of the pain syndrome, which becomes permanent. As a result, the mobility of the joint decreases, the patient tries to unload the injured leg, which causes a significant atrophy of the hip muscles.
- The third stage is accompanied by intense pain, which occurs even under small loads. Because of this, the motor function of the joint deteriorates, marked lameness and atrophy of the muscles not only of the thigh, but also of the shin. Sometimes the shortening of the sore leg is markedly noticeable.
- At the fourth stage, pathology provokes almost complete destruction of bone tissue, a person can not move without help or special adaptations.
X-ray in aseptic necrosis of the femoral head
The X-ray examination is the most informative and accurate diagnostic method.
The photographs clearly show areas of necrosis with rarefied or thickened bone in the femoral joint, uneven head, changes in the shape of the cavity on the femur, marginal osteophytes. Thanks to the X-ray, you can accurately determine the stage of the disease.
Additional diagnostic methods:
- Podography;
- measurement of support and walking parameters;
- MRI;
- definition of intraosseous pressure.
Treatment and surgical correction of aseptic necrosis of the femoral head
An integrated approach in the treatment of the ailment considered is as follows:
- Medical gymnastics and compliance with orthopedic regimens. Moderate stresses on the affected joint are shown.
- Correction of walking. Especially recommended multichannel electrical stimulation.
- Drug treatment. Vascular (Kurantil), pain relievers (Ibuprofen), chondroprotectors (Rumalon, Mukartrin), regulators
calcium metabolism (Alfacalcidol with Xidiphon). - Decompression tunneling with prolonged blockade (autograft in mixture with Novokain, Kurantil).
- Intra-articular infections. A vitreous with oxygen is used.
Important and physiotherapy for aseptic necrosis of the head of the femur - laser, magnetic, EHF.
If the presented treatment scheme is ineffective, surgical intervention is prescribed:
- rotational osteotomy;
- autoplasty of the femoral head of the subchondral type.