GLUCOCORTICOID-INDUCED ARTHRITIS OF HIP

Аннотация

Glucocorticoid use is one of the commonest and most important causes of non-traumatic ON. Postulated pathogenetic mechanisms of glucocorticoid-induced ON include fat hypertrophy, fat emboli and intravascular coagulation. MRI is the gold standard diagnostic method to detect ON in the early stage. Preservation of the native hip is the goal of treatment for young and active patients. Early diagnosis and intervention prior to collapse of the femoral head is the key to a successful outcome of joint preserving procedures. There are no specific biomarkers for ON diagnostic. There is not a gold standard treatment and frequently it is necessary a multi - disciplinary approach. Replacement procedure remains the gold standard treatment after failure of preserving procedures and in the late - stage ON, involving collapse of the femoral head and degenerative changes to the acetabulum. More recently, reports have shown excellent results, but implant longevity and following revisions are still outstanding problems.