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Osteonecrosis in pediatric cancer survivors: Epidemiology, risk factors, and treatment
Sandesh S Rao1, Jad M El Abiad1, Varun Puvanesarajah1
1Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Abstract:
Several treatment regimens for childhood malignancies have been associated with the development of osteonecrosis, including radiation therapy, glucocorticoid medications, immunotherapy (including anti-angiogenic agents), and several chemotherapeutic agents. Adolescents older than 10 years are at greatest risk of developing osteonecrosis within 1 year of initiating therapy. Screening with magnetic resonance imaging in this high-risk population may be a useful method for detecting osteonecrosis. Surgery may be required for lesions that have progressed substantially despite nonoperative interventions.
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