Osteonecrosis of the femoral head: current concepts of treatment (review)

The purpose of the analytical review is to analyze the literature on the results of treatment of patients with aseptic necrosis of the femoral head. Methods. Literary sources were searched in open scientific literature electronic databases, such as PUBMED, SCOPUS, and E-library. Search depth: 8 years. Results. 18 full-text publications for research analysis found. 18 sources. We would like to point out that early diagnosis and timely treatment before the collapseof the femoral head is the key to hip joint preservation. When choosing the optimal approach to the treatment of aseptic necrosis of the femoral head, one should note the following factors: necrosis stage, osseous lesion localization, clinical findings and the patient’s concomitant diseases. The treatment goal is to preserve the biological hip joint for as long as possible, taking into account such aspects of the patient’s quality of life, as age mobility, occupation and lifestyle. The three main treatment options are conservative treatment, organ-preserving surgery, and total hip replacement. Non-surgical methods have a limited role in the treatment of aseptic necrosis. The most common surgical treatment methods include several variations of decompression of the necrosis lesion in the femoral head, including decompression using cell-based, osteogenic and osteo-inductive technologies. Conclusions. Aseptic necrosis of the femoral head continues to be a challenging problem for orthopedic traumatologists, since the causes and pathogenic mechanisms of this condition have not yet been fully clarified. Diagnosis at early stages helps to preserve the hip joint. Various methods of organ-preserving surgeries demonstrate the possibility of preserving the femoral head. Various decompression options have proven to be a safe and effective treatment option. Cell-based therapy, osteogenic and osteo-inductive agents show encouraging results.