TY  - CHAP
M1  - Book, Section
TI  - Osteonecrosis (Avascular Necrosis of Bone)
A1  - Manno, Rebecca L.
A1  - Yazdany, Jinoos
A1  - Tarrant, Teresa K.
A1  - Kwan, Mildred
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
PY  - 2023
T2  - Current Medical Diagnosis & Treatment 2023
AB  - Osteonecrosis  is  a  complication  of  corticosteroid  use,  alcohol  use,  trauma,  SLE,  pancreatitis,  gout,  sickle  cell  disease,  dysbaric  syndromes  (eg,  “the  bends”),  and  infiltrative  diseases  (eg,  Gaucher  disease).  The  most  commonly  affected  sites  are  the  proximal  and  distal  femoral  heads  (eFigure  20–44),  leading  to  hip  or  knee  pain.  Other  commonly  affected  sites  include  the  ankle,  shoulder,  and  elbow.  Osteonecrosis  of  the  jaw  is  associated  with  the  dose-related  use  of  bisphosphonates,  usually  when  high-dose  intravenous  bisphosphonate  therapy  is  used  for  treating  metastatic  cancer  or  plasma  cell  myeloma  rather  than  osteoporosis.  Initially,  radiographs  are  normal;  MRI,  CT  scan,  and  bone  scan  are  more  sensitive  techniques.  Treatment  involves  avoidance  of  weight  bearing  on  the  affected  joint  for  at  least  several  weeks.  The  value  of  surgical  core  decompression  is  controversial.  For  osteonecrosis  of  the  hip,  a  variety  of  procedures  designed  to  preserve  the  femoral  head  have  been  developed  for  early  disease,  including  vascularized  and  nonvascularized  bone  grafting  procedures.  These  procedures  are  most  effective  in  avoiding  or  forestalling  the  need  for  total  hip  arthroplasty  in  young  patients  who  do  not  have  advanced  disease.  Without  intervention,  the  natural  history  of  avascular  necrosis  is  progression  of  the  bony  infarction  to  cortical  collapse,  resulting  in  significant  joint  dysfunction.  Total  hip  replacement  is  the  usual  outcome  for  all  patients  who  are  candidates.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1193126133
ER  -