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Steroid-induced osteonecrosis: a review

R L Cruess

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |November 1, 1981
    PubMed
    Summary

    Cortisone-induced osteonecrosis, often affecting the femoral head, can occur in patients with renal transplants or other conditions. Fat metabolism alterations are the likely cause, with conservative treatment preferred but surgery also effective.

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    Area of Science:

    • Orthopedics
    • Endocrinology
    • Pathology

    Background:

    • Cortisone-induced osteonecrosis is a recognized complication.
    • It has been observed in patients undergoing renal transplantation and those with other medical conditions.

    Purpose of the Study:

    • To analyze the incidence, patterns, and potential causes of cortisone-induced osteonecrosis.
    • To evaluate treatment outcomes for this condition.

    Main Methods:

    • Retrospective review of 122 patients diagnosed with cortisone-induced osteonecrosis between 1963 and 1980.
    • Analysis of affected bone locations, patterns of involvement, and patient conditions.

    Main Results:

    • The femoral head was the most commonly affected site in 122 patients.
    • Two patterns of osteonecrosis were observed: subchondral osteolysis and a pattern resembling osteochondritis dissecans.
    • Alterations in fat metabolism, leading to vascular occlusion and bone death, are implicated.

    Conclusions:

    • Cortisone-induced osteonecrosis presents with distinct patterns and commonly affects the femoral head.
    • Fat metabolism disturbance is the probable etiology.
    • Conservative management is recommended, though surgical interventions can yield positive results.

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