Circulatory Disorders

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Necrosis of the Femoral Head

Femoral head necrosis involves a circulatory disorder of the femur that forms the hip joint. Femoral head necrosis can have various causes, including accidents, joint malalignment with overloading, cortisone therapy, smoking, and excessive alcohol consumption. It is not always possible to clarify the cause of the circulatory disorder.

When is surgery needed?

Due to femoral head necrosis, the bone forming the joint becomes less resilient and can collapse. This leads to a joint injury with painful restriction of movement. To avoid this progression, early surgery is recommended.

What happens during surgery?

In the early stages of the circulatory disorder, an improvement in blood flow can be achieved by surgical drilling of the femur in the area of the femoral head necrosis. In certain cases, improved loading of the femoral head can also be achieved through corrective osteotomy of the femur. However, if the entire area no longer has a blood supply and the femoral head has already collapsed, an artificial hip joint replacement is required. The surgery is performed under inpatient conditions.

Aftercare

Mobilisation begins on the first day after the operation with the aid of physiotherapy and forearm crutches. The operated joint/leg must not be fully weight-bearing for 3 to 6 weeks. During this period, temporary partial weight-bearing with forearm crutches must be observed. Medical thrombosis prophylaxis is required for this duration. After inpatient discharge, physiotherapy should be continued, possibly in the form of inpatient or outpatient rehabilitation. As a rule, a rehabilitation period of 12 weeks is to be expected after drilling of the femur. Patients should anticipate a period of incapacity for work lasting 3 months.