Core decompression of the femoral head. Literature review

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Abstract

Avascular necrosis (AVN) of the femoral head is a disease, characterized by the death of osteocytes and bone marrow, leading to collapse of the femoral head and dysfunction of the hip joint. There are many known risk factors for the development of this disease including trauma of the hip joint, hemoglobinopathy, alcoholism, taking corticosteroids, collagenosis, etc. Conservative treatment (drug therapy using vascular drugs, bisphosphonates, chondroprotectors, NSAIDs, physiotherapy, exercise therapy) is shown for any stage of the hip AVN, however, surgical treatment has a higher potential. The key to successful treatment is the detection of AVN at an early (pre-collapse) stage to prevent subsequent collapse by performing organ-sparing surgical interventions that reduce the rate of disease progression and allow delaying of the hip replacement. The literature describes a number of organ-preserving operations performed at an early stage of AVN. Currently, there are three main areas of surgical treatment of this disease: classical decompression of the femoral head, decompression using various types of grafts and combined treatment using various cellular technologies. This literature review is devoted to the consideration of the indications for implementation, as well as the results of treatment of patients using the above techniques.

About the authors

Mikhail A. Panin

Peoples Friendship University of Russia

Email: panin-mihail@yandex.ru
ORCID iD: 0000-0003-4686-7892
SPIN-code: 5834-3500

Cand. Sci. (Med.)

Russian Federation, 6 Miklouho-Maclay str., Moscow, 117198

Nikolay V. Zagorodniy

Peoples Friendship University of Russia; N.N. Priorov National Medical Research Center

Email: zagorodniy51@mail.ru
SPIN-code: 6889-8166

Dr. Sci. (Med), Professor, Corresponding Member of the Russian Academy of Medical Sciences

Russian Federation, 6 Miklouho-Maclay str., Moscow, 117198; Moscow

Medetbek D. Abakirov

Peoples Friendship University of Russia

Email: medetbek@mail.ru
ORCID iD: 0000-0002-5842-5904
SPIN-code: 5099-0493

Cand. Sci. (Med.)

Russian Federation, 6 Miklouho-Maclay str., Moscow, 117198

Andrey V. Boyko

Peoples Friendship University of Russia

Author for correspondence.
Email: boiko120393@gmail.com
ORCID iD: 0000-0002-7829-2045
SPIN-code: 4543-7879

postgraduate student

Russian Federation, 6 Miklouho-Maclay str., Moscow, 117198

Danila A. Ananyin

Peoples Friendship University of Russia

Email: ananuins@list.ru
ORCID iD: 0000-0003-0032-4710
SPIN-code: 1446-8368

Cand. Sci. (Med.)

Russian Federation, 6 Miklouho-Maclay str., Moscow, 117198

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