Roberts Tsamara, Penn Amanda, Hanson Logan
College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Department of Orthopedic Surgery, Bond Clinic, Winter Haven, USA.
Cureus. 2025 Jun 29;17(6):e86976. doi: 10.7759/cureus.86976. eCollection 2025 Jun.
Avascular necrosis (AVN) of the femoral head results from disrupted blood flow that leads to bone tissue death. Nontraumatic risk factors include long-term corticosteroid use, excessive alcohol consumption, autoimmune diseases, and hematological disorders. Without an adequate blood supply, osteocytes die, causing microfractures that lead to structural collapse of the femoral head. Disruption of joint biomechanics causes hip or groin pain and limited range of motion (ROM). This case report presents a 56-year-old male patient with severe left hip pain and progressive functional decline over nine months. Imaging confirmed stage IV AVN with complete femoral head collapse. The patient failed initial conservative measures and underwent a cementless total hip arthroplasty (THA) augmented with peripheral screws in the acetabular cup. Post-operative recovery was unremarkable, with reported improvement of pain and increased hip motion at the six-week follow-up. This case highlights the importance of early diagnosis and treatment in advanced avascular necrosis of the femoral head. It also demonstrates the effectiveness of cementless total hip arthroplasty in providing good clinical outcomes.
股骨头缺血性坏死（AVN）是由血流中断导致骨组织死亡引起的。非创伤性危险因素包括长期使用皮质类固醇、过量饮酒、自身免疫性疾病和血液系统疾病。由于没有足够的血液供应，骨细胞死亡，导致微骨折，进而导致股骨头结构塌陷。关节生物力学的破坏会引起臀部或腹股沟疼痛以及活动范围（ROM）受限。本病例报告介绍了一名56岁男性患者，其左髋部剧痛，九个月来功能逐渐衰退。影像学检查确诊为IV期AVN，股骨头完全塌陷。患者最初的保守治疗失败，接受了在髋臼杯处用外周螺钉增强的非骨水泥全髋关节置换术（THA）。术后恢复情况良好，六周随访时报告疼痛有所改善，髋关节活动增加。本病例突出了股骨头晚期缺血性坏死早期诊断和治疗的重要性。它还证明了非骨水泥全髋关节置换术在提供良好临床效果方面的有效性。
