Treatment results in aseptic necrosis of the femur head

: Between 1.01.1987 and 31.12.1997, 40 patients (52 hips) were diagnosed with avascular necrosis of the femoral head (ANFH) and treated in the Emergencies Hospital of Iasi. ANFH was detected by clinical findings, plain radiographs and computed tomographic scans. We used the classification of Ficat and Arlet and the choice of treatment between core decompression (20 hips), flexion osteotomy (10), rotation osteotomy (4) or total hip arthroplasty (18) was determined by the stage and location of the area of necrosis. Core decompression has been attempted in patients with Ficat stages I and II, trochanteric osteotomy has been used in Ficat stages II and III, and in the most advanced stages of necrosis (Ficat stage III and stage IV) total hip arthroplasty was the procedure of choice. We reviewed the patients at 3, 6 and 12 months after the surgery. The results were evaluated using Merle D'Aubigne score. We noted good and very good results in 75% of our patients which were diagnosed in the early stages of necrosis. We concluded that the earlier diagnostic and the correct indication of treatment (determined by the stage of necrosis) are the premise for the amelioration of the severe prognostic of ANFH.