Avascular necrosis of the femoral head

Written by Mustafin R.N., Khusnutdinova E.K.

  UDK: 616.718.41-002.4 | Pages: 27–35 | Full text PDF | Open PDF 

Avascular necrosis of the femoral head is a multifactorial disease with progressive development of severe secondary coxarthrosis. There are two types of necrosis – secondary and idiopathic. The pathogenesis of the disease is associated with the local blood circulation disorders, coagulopathies and violation of bone tissue regeneration. A bone with a histologic lesion is characterized by the formation of empty lacunae with vascularized fibrous tissue around it, and the osteoclast activity increases in the subchondral and necrosis zone, while in the sclerosis zone the osteoblast activity enhance. Among the laboratory parameters determined a significant increase in the levels of inhibitor 1 plasminogen activator, Willebrand factor, inhibitor 1 plasminogen activator, C-reactive protein, interleukin 33, a decrease of the ghrelin and osteoprotegerin levels, cross-linked N-terminal telopeptide, the C-terminal peptide of procollagen 1, tumor necrosis factor α, miR-17-5p. In genetic studies revealed mutations in the gene COL2A1 and prothrombin, the association of polymorphic loci of genes for factor V Leiden, methylenetetrahydrofolate, tissue-specific plasminogen activator inhibitor 1, plasminogen activator. Treatment includes surgery and correction of the cytological activity. There is evidence for the ability of bisphosphonates to prevent the collapse of the femoral head.

Links to authors:

R.N. Mustafin1, E.K. Khusnutdinova1, 2
1 Bashkir State University (32 Zaki Validi St. Ufa 450076 Russian Federation),
2 Institute of Biochemistry and Genetics, Ufa Research Center (71 Oktyabrya Ave. Ufa 450054 Russian Federation)

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