Guerado Enrique, Caso Enrique
Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol. University of Malaga, Spain.
Research Unit, Hospital Universitario Costa del Sol. University of Malaga, Spain.
Injury. 2016 Dec;47 Suppl 6:S16-S26. doi: 10.1016/S0020-1383(16)30835-X.
The physiopathology of the femoral head bone necrosis is similar for children and for adults. The disease is characterized by apoptosis of bone cells - bone marrow and bone forming cells-resulting in head collapse with a subsequent lesion of the overlying cartilage, and therefore flattening of the rounded surface shape of the head articulating with the acetabulum, provoking, eventually, secondary osteoarthritis. When the disease becomes clinically evident already destructive phenomena have occurred and collapse will eventually ensue. In children, because epiphyseal cartilage has growth capabilities, lost epiphyseal height can be recovered, however in adults collapse is irreversible. In this paper the physiopathology of this disease is examined as well as its implication for treatment. Prevention by genetic studies is discussed.
儿童和成人股骨头骨坏死的生理病理学相似。该疾病的特征是骨细胞（骨髓细胞和骨形成细胞）凋亡，导致股骨头塌陷，继而损伤上方的软骨，进而使与髋臼相关节的股骨头圆形表面变平，最终引发继发性骨关节炎。当疾病在临床上明显表现出来时，已经发生了破坏性现象，最终将会出现塌陷。在儿童中，由于骨骺软骨具有生长能力，失去的骨骺高度可以恢复，然而在成人中，塌陷是不可逆的。本文研究了该疾病的生理病理学及其对治疗的影响。还讨论了通过基因研究进行预防的问题。
