Osteonecrosis

Osteonecrosis is a disease caused by reduced blood flow to bones in the joints, including the hip, knee, shoulder, and ankle. The disease, which is usually progressive and leads to joint failure, occurs in young adults aged from their twenties to their fifties. The pathogenesis of osteonecrosis is still unclear, and treatment remains controversial. This book provides up-to-date and comprehensive information on the pathophysiology, etiology, diagnosis, classification, and treatment of osteonecrosis. The role of various imaging modalities is considered, and both non-surgical and surgical treatment approaches are clearly explained. The contributions, all from experts in the field, are based on presentations at leading international meetings during the past 10 years and on peer-reviewed papers. The book will be of interest not only to clinical practitioners but also to those engaged in basic research.

Part 1. History.- Historical Perspective.- Part 2. Anatomy and blood flow.- Vascular Anatomy and Blood Supply to The Femoral Head.- Ischemia and Reperfusion Injury in Bone.- Part 3. Epidemiology.- Epidemiology of Osteonecrosis in The Europe.- Epidemiology of Osteonecrosis in The United States.- Epidemiology of Osteonecrosis in The Japan.- Epidemiology of Osteonecrosis in The South Korea.- Epidemiology of Osteonecrosis in The Taiwan and China.- Part 4. Etiology.- Genetic Studies in Osteonecrosis of The Femoral Head.- Osteonecrosis and Intravascular Coagulation Revisited.- Glucocorticoids as An Etiologic Factor.- Corticosteroid Usage and Osteonecrosis of The Hip.- Alcohol.- Traumatic Osteonecrosis of The Femoral Head.- Posttraumatic Osteonecrosis of The Femoral Head.- Osteonecrosis in Sickle Cell Disease.- Autoimmune disease and Other Risk Factor.- Part 5. Pathology.- Pathophysiology of Ischemic Diseases of The Hip; Osteonecrosis, Borderline Necrosis and Bone Marrow Edema Syndrome.- ThePathology of Osteonecrosis of The Femoral Head.- Part 6. Clinical Manifestation.- Natural history of Osteonecrosis.- Causes of Pain in Early Stage and Advanced Stage.- Accumulation of Necrotic Fatty Marrow in Osteonecrotic Hips Mimicking Septic Arthritis.- Part 7. Imaging Diagnosis.- Radiography, MRI, CT, Bone scan, PET-CT.- Part 8. Staging and Classification.- Ficat Staging System for Osteonecrosis of The Femoral Head.- The University of Pennsylvania Classification Systems for Osteonecrosis of The Femoral Head.- The Japanese Investigation Committee Classification for Osteonecrosis of The Femoral Head.- Modified Kerboul Classification System for osteonecrosis of The Femoral Head.- ARCO staging system : Generation and Evolution Since 1991.- Part 9. Differential Diagnosis.- Subchondral Stress Fracture of the Femoral Head.- Bone Marrow Edema Syndrome of the Hip.- Distinguishing Bone Marrow Edema Syndrome from Osteonecrosis.- Part 10. Non-surgical Treatments.- Treatment of Osteonecrosis ofThe Hip and Knee with Enoxaparin.- The Role of Coagulopathy in The Pathogenesis and Prevention of Corticosteroid-Induced Osteonecrosis.- Lipid Lowering Agents and Their Effect on Osteonecrosis: Pros and Cons.- Is There a Role for Bone morphogenetic proteins in The Treatment of Osteonecrosis?.- Alendronate in The Prevention of Collapse of The Femoral Head in Non-Traumatic Osteonecrosis.- New Therapies of The Osteonecrosis.- Part 11. Surgical Treatments.- Principles of Core Decompression for Osteonecrosis of The Hip.- Stem Cells in Osteonecrosis: Cons.- Cement Techniques in Hip Osteonecrosis with Collapse: From Traditional Methyl Methacrylate to Bone Substitutes and Stem Cells.- Impaction Bone Graft.- Principles of Bone Grafting for Osteonecrosis of the Hip.- Iliac bone graft.- Vascularized Pedicle Iliac Bone Grafting for Osteonecrosis of The Femoral Head: Data, Dogma, and Controversies.- Transtrochanteric Rotational Osteotomy for Femoral Head Osteonecrosis.- Posterior Rotational Osteotomy for Severe Femoral Head Osteonecrosis.- Transtrochanteric Curved Varus Osteotomy for The Treatment of Osteonecrosis of The Femoral Head.- Total Hip Arthroplasty Using Ceramic-On-Ceramic Articulation.- Highly Cross-Linked Polyethylene in Patients with Osteonecrosis of The Femoral Head in The United States and Europe.- Alumina Ceramic on Highly Cross-Linked Polyethylene Bearing Surfaces in Cementless Total Hip Arthroplasty in Young Patients with Osteonecrosis of Femoral Head.- Hip Arthroplasty for Osteonecrosis of the Femoral Head.- Resurfacing Arthroplasty for Osteonecrosis of the Femoral Head.- Part 12. Osteonecrosis in Bones: Other than The Hip.- Multifocal Osteonecrosis.- Osteonecrosis of the Humeral Head.- Osteonecrosis of the Knee.- Osteonecrosis of the Talus.- Kienböck’s disease of the Lunate.- Part 13. Legg-Calve-Perthes Disease.- Epidemiology and Etiology.- Pathology, Pathophysiology, and Pathogenesis of Deformity.- Diagnosis, Imaging and Classifications.- Treatment.- Developing Medical Therapy.- Corticosteroid Associated Osteonecrosis in Children.- Part 14. Animal Models.- Animal Models of Corticosteroid Associated Bone Diseases.- Animal Models of Osteonecrosis – an overview.

Dr. Quanjun Cui is the G.J. Wang M.D. Professor of Orthopaedic Surgery and Vice Chair for Research, Department of Orthopaedic Surgery, University of Virginia School of Medicine. He is a board-certified orthopaedic surgeon and specialized in total hip and knee replacement. Dr Cui’s research has been funded by NIH and DOD focusing on osteogenesis and arthritis. He has received numerous academic and professional accolades, including the Hip Society Otto Aufranc Award. He is a board member and reviewer for several prestigious journals. Dr. Cui is a fellow of the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Association (AOA). He served as President of the Virginia Orthopaedic Society in 2017 and President of the Association Research Circulation Osseous (ARCO) in 2020.

Dr. Kyung-Hoi (Kay) Koo is a musculoskeletal radiologist as well as an orthopaedic surgeon. During last 30 years, he has exclusively performed hip surgeries. He is interested in femoral head osteonecrosis and has actively participated in ARCO since 1994. He was President of ARCO from 2012 to 2015. Since 1997, he has used ceramic-on-ceramic bearings in total hip arthroplasty and has been instrumental in bringing ceramic-on-ceramic total hip arthroplasty. He has published over 300 peer-reviewed articles and more than 20 book chapters regarding femoral head osteonecrosis and total hip arthroplasty. He was an editor of the Bone and Joint Journal from 2015 to 2018 and currently, he is an editor of the Journal of Arthroplasty. 

Lynne C. Jones, Professor, Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine

Michael A. Mont, MD Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics Director, Joint Preservation and Reconstruction