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Hypercholesterolemia: an association with osteonecrosis of the femoral head
J T Moskal1, R E Topping, L L Franklin
1Roanoke Orthopaedic Center, Virginia, USA.
Insights
High cholesterol may be linked to idiopathic avascular necrosis. This study found elevated serum cholesterol in most patients with this condition, suggesting a potential connection in bone disease development.
Area of Science:
- Orthopedics
- Cardiology
- Biochemistry
Background:
- Idiopathic avascular necrosis of the femoral head is a debilitating condition.
- Potential risk factors for avascular necrosis are being investigated.
Purpose of the Study:
- To investigate the association between hypercholesterolemia and idiopathic avascular necrosis of the femoral head.
- To determine if elevated serum cholesterol levels are a risk factor for this condition.
Main Methods:
- Serum cholesterol levels were measured in patients diagnosed with idiopathic avascular necrosis of the femoral head.
- Patients with known risk factors were excluded from the analysis.
- Results were compared to age-matched control standards.
Main Results:
- 16 out of 19 patients (84%) with idiopathic avascular necrosis had statistically elevated serum cholesterol levels (mean 254 mg/dL).
- Four patients were on cholesterol-lowering medication.
- 12 of the 16 patients (75%) had bilateral avascular necrosis, suggesting a systemic factor.
Conclusions:
- Elevated serum cholesterol levels are associated with idiopathic avascular necrosis of the femoral head.
- Hypercholesterolemia may play a role in the pathophysiology of osteonecrosis.
- Further research is warranted to confirm this association and explore therapeutic implications.
Abstract:
To determine whether hypercholesterolemia is an associated factor for idiopathic avascular necrosis, serum cholesterol levels were measured in all patients presenting with idiopathic avascular necrosis of the femoral head from December 1987 to December 1995. Of 77 patients, with 114 affected hips, presenting with avascular necrosis of the femoral head, 58 patients, with 81 affected hips, were excluded for known associated risk factors. Of the remaining 19 patients (33 hips) who were diagnosed with idiopathic avascular necrosis, 16 had serum cholesterol levels that were statistically elevated (mean value, 254 mg/dL) compared with accepted age-matched control standards (P < 0.0031). Four of the 16 patients were taking cholesterol-lowering medications at the time of initial evaluation and testing. In addition, 12 of the 16 patients had bilateral avascular necrosis, suggesting that the systemic effect of hypercholesterolemia may be involved in the pathophysiology of osteonecrosis. These results suggest an association between elevated serum cholesterol levels and idiopathic avascular necrosis of the femoral head.