Hüftkopfnekrose

Hüftkopfnekrose, also known as avascular necrosis of the femoral head or osteonecrosis of the femoral head, is a condition characterized by the death of bone tissue in the ball-shaped top of the femur (thigh bone), which is part of the hip joint. This death of bone occurs because the blood supply to the femoral head is interrupted or damaged, preventing the bone cells from receiving oxygen and nutrients.

The causes of Hüftkopfnekrose are varied and can include trauma, such as a hip fracture or dislocation, which can directly damage the blood vessels supplying the femoral head. Non-traumatic causes are also common and include prolonged use of corticosteroid medications, excessive alcohol consumption, certain medical conditions like sickle cell disease, lupus, and Gaucher disease, as well as radiation therapy. Idiopathic Hüftkopfnekrose, where no clear cause can be identified, also occurs.

Symptoms typically begin with a dull ache or throbbing pain in the groin, buttock, or thigh. As the condition progresses and the bone weakens, the pain can worsen, especially during weight-bearing activities. This can lead to a limp and limited range of motion in the hip joint. In advanced stages, the femoral head can collapse, leading to severe pain and osteoarthritis of the hip.

Diagnosis involves a combination of medical history, physical examination, and imaging studies. X-rays can initially show changes in the bone, but they may not be apparent in the early stages. MRI scans are more sensitive for detecting early signs of avascular necrosis. Treatment depends on the stage of the disease and may range from conservative measures like pain management, restricted weight-bearing, and medications to reduce bone breakdown, to surgical interventions. Surgical options can include core decompression to relieve pressure, osteotomy to realign the bone, or ultimately, hip replacement surgery if the femoral head has collapsed.