Moon Jun Gyu, Shetty Gautam M, Biswal Sandeep, Shyam Ashok Kumar, Shon Won Yong
Department of Orthopedic Surgery, Korea University Guro Hospital, Guro-gu, Seoul, South Korea.
Arch Orthop Trauma Surg. 2008 Oct;128(10):1149-52. doi: 10.1007/s00402-007-0563-9. Epub 2008 Jan 15.
Alcohol-induced osteonecrosis of femoral head is common but multifocal osteonecrosis secondary to alcohol is very rare. The authors report one case of multifocal alcohol-induced osteonecrosis involving both hips and both knees and its subsequent progression and management over a period of 14 years. There was bilateral involvement of hips in pre-collapse stage for which a core decompression was done. The left hip responded well and at 14-year follow-up was asymptomatic with full range of motion. The core decompression surgery failed in the right hip within 1 year and subsequently hybrid total hip replacement arthroplasty was done with good functional results at 13 years follow-up. The diagnosis of knee osteonecrosis was most probably missed initially and was subsequently diagnosed 6 months back due to symptoms of pain and radiographic findings for which a core decompression was done with good early results. The results of treatment of hip was excellent in our patient and despite the rarity, a high degree of suspicion and regular screening is necessary to detect involvement of other areas like the knee in alcohol-induced osteonecrosis.
酒精性股骨头坏死很常见，但继发于酒精的多灶性骨坏死非常罕见。作者报告了一例累及双髋和双膝的多灶性酒精性骨坏死病例，以及其在14年期间的后续进展和治疗情况。双侧髋关节处于塌陷前期，为此进行了髓芯减压术。左侧髋关节反应良好，在14年随访时无症状，活动范围正常。右侧髋关节在1年内髓芯减压手术失败，随后进行了混合式全髋关节置换术，在13年随访时功能结果良好。膝关节骨坏死最初很可能被漏诊，6个月前因疼痛症状和影像学表现而被诊断出来，为此进行了髓芯减压术，早期效果良好。我们患者的髋关节治疗结果极佳，尽管罕见，但对于酒精性骨坏死，高度怀疑并定期筛查以检测膝关节等其他部位的受累情况是必要的。
