PATHOGENESIS/PATHOPHYSIOLOGY

RECURRENT OSTEONECROSIS OF THE FEMORAL HEAD

Hee Joong Kim, Sang-Hong Lee*, Young-Min Kim
Department of Orthopaedic Surgery, Seoul National University, Seoul, Korea
*Department of Orthopaedic Surgery, Chosun University, Kwang-ju, Korea

Between September 1997 and August 1999, we experienced three cases of recurrent ONFH in three patients. They were 47-year-old man, 25-year-old woman and 54-year-old man. The evidence of recurrent ischemic episodes was found on MR images. In one case, recurrence was confirmed by histological examination.

All patients had bilateral ONFH and the evidence of two different ischemic attacks was found in only one femoral head. No patient had a risk factor for ONFH. Two patients, who took blood tests for coagulability, demonstrated the tendency of increased blood coagulability.

It seems that an increase in the extent of necrosis by recurrent episodes of ischemia is rare. However, these cases suggest that salvage operations may fail because of additional ischemic attacks. Further studies are necessary to find out the relationship between the recurrent episodes of ischemia and hypercoagulability.