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41
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Preventing Avascular Necrosis of the Femoral Head & Its Misdiagnosis: a Special Interview
with Prof Feng JianMin: Orthopedic Department, Ruijin Hospital, Shanghai
Congenital hip dysplasia or rheumatoid arthritis may be misdiagnosed as avascular necrosis (AVN) of the femoral (thigh bone)
head that has elusive mechanisms; predisposing factors are: (1) Prolonged steroids (e.g., for kidney diseases, systemic lupus
erythematosis, “rheumatism”, rheumatoid arthritis, etc.) causing osteoporosis, degenerative bone changes, impeded arterial flow and
AVN (2) Alcoholism causes osteoporosis and liver damage, high blood cholesterol levels and thicker blood that impedes blood flow
(3) “Rheumatism” (4) Traumatic factors: dislocation of the hip; fracture of the femoral neck; hip joint congenital abnormalities, etc.,
impedes the blood supply of the femoral head: better avoid sudden, forceful exertions of the hip (5) Mixed factors, e.g., alcoholism
with more frequent falls: abrupt bone stress ensues; rheumatoid arthritis with long-term steroids, etc. Treatment of early stage AVN: by
reducing weight bearing, e.g., through rehabilitation and ultra-sound therapy; surgically, core decompression, bone grafting; titanium
metal rod placement; vascular bone fragment implant, etc. For late stages, arthroplasty is required.
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