Bilateral Osteonecrosis Associated with Corticosteroid Treatment: Stem Cell Therapy Versus Core Decompression in the Same Patient

This chapter presents the long-term results of stem cell therapy and core decompression in a patient with bilateral osteonecrosis of the femoral head. This case demonstrates that persistent hip pain, especially with joint movement, tenderness, or reduced range of motion, warrants magnetic resonance imaging because of the association of glucocorticoid therapy with osteonecrosis. The pathognomonic, subchondral crescent sign seen on radiographic examination may not be present in the early stages of osteonecrosis, and MRI can reveal extensive osteonecrosis before any change in the shape of the femoral head or appearance of a fracture crescent on X-rays.