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[Osteoradionecrosis of the hip joint]
C Aigner1, R Ehall, O Stampfel
1Klinische Abteilung für Orthopädie, Universitätsklinik für Chirurgie Graz.
Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|September 1, 1995
Summary
Radiation-induced osteonecrosis of the hip is a rare complication appearing 2-17 years post-radiation. Surgical treatment with total hip replacement (THR) showed acetabular healing and reduced sclerosis without further damage.
Area of Science:
- Orthopedic Surgery
- Radiation Oncology
- Radiology
Background:
- Radiation-induced osteonecrosis (ONJ) of the hip is a rare but serious complication following radiotherapy.
- Latency period for hip ONJ is significantly longer (2-17 years) compared to other skeletal sites.
- An inverse correlation exists between patient age at radiotherapy and the time to ONJ manifestation.
Observation:
- Radiographic findings include femoral head migration, focal lysis, sclerosis, and fractures.
- Differential diagnosis from neoplastic changes requires advanced imaging like bone scan and MRI.
- Five patients with hip ONJ were evaluated, with four undergoing surgical intervention.
Findings:
- Surgical treatment, specifically total hip replacement (THR), led to healing of fractured acetabulae within 9 months.
- Post-operative follow-up demonstrated diminished sclerosis in the affected bone.
- No progression of radiation-induced damage was observed after surgical management.
Implications:
- THR is an effective treatment for radiation-induced osteonecrosis of the hip, promoting bone healing and symptom resolution.
- Early diagnosis and appropriate management are crucial for improving outcomes in patients with hip ONJ.
- Understanding the long latency period and age correlation aids in patient monitoring and risk assessment for radiation-induced bone complications.