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Aseptic necrosis of the femoral head is considered to be an avascular necrosis of the femoral head with unknown origin and may sometimes degenerate adult hip joints. Many instances of this lesion result in arthrosis secondarily and consequently the activity of daily life are disturbed.We have 17 cases or 23 joints of aseptic necrosis of the femoral head during 9 years from 1972 to 1980. The cause and the therapy of aseptic necrosis of the femoral head were reported in this article.Steinberg described more than twenty causes of aseptic necrosis. In our 17 cases, 6 cases were so-called idiopathic necrosis, 5 were induced by steroid, 3 by alcohol and liver dysfunction and other 3 by femoral neck fractures.These 17 cases or 23 joints were divided into 3 types according to the x-ray findings of collapse types at initial examination.Fifteen joints were condense type, 7 were compression type and only one joint was saucer type. Of these 15 joints of condense type at initial examination, 9 joints became compression type within 2 years and the number of saucer type increased from one joint to four. Progression of aseptic necrosis was seen in all cases including arthroplasty. Eight joints were treated conservatively and others were treated operatively.Based on these findings, we suggested the following therapeutic regimen according to the etiology of aseptic necrosis. Patients with so-called idiopathic necrosis of the femoral head should be treated conservatively with mainly non-weight bearing exercise and if the progression of illness was found, operation by bone-nailing and arthroplasty should be done considering patients' ages. Patients with steroid-induced aseptic necrosis might progress to articular-ankylosis more rapidly than other cases if no therapy was done, and therefore arthroplasty should be considered in earlier stages than other cases.
一般社団法人国立医療学会の論文

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一般社団法人国立医療学会 | 論文

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一般社団法人 国立医療学会 | 論文

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一般社団法人国立医療学会 | 論文