Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today? A 5-Year Update

Michael A. Mont, Hytham S. Salem, Nicolas S. Piuzzi, Stuart B. Goodman, Lynne C. Jones

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Clinicians should exercise a high level of suspicion in at-risk patients (those who use corticosteroids, consume excessive alcohol, have sickle cell disease, etc.) in order to diagnose osteonecrosis of the femoral head in its earliest stage. Nonoperative treatment modalities have generally been ineffective at halting progression. Thus, nonoperative treatment is not appropriate in early stages when one is attempting to preserve the native joint, except potentially on rare occasions for small-sized, medially located lesions, which may heal without surgery. Joint-preserving procedures should be attempted in early-stage lesions to save the femoral head. Cell-based augmentation of joint-preserving procedures continues to show promising results, and thus should be considered as an ancillary treatment method that may improve clinical outcomes. The outcomes of total hip arthroplasty in the setting of osteonecrosis are excellent, with results similar to those in patients who have an underlying diagnosis of osteoarthritis.

Original languageEnglish (US)
Pages (from-to)1084-1099
Number of pages16
JournalJournal of Bone and Joint Surgery
Issue number12
StatePublished - Jun 17 2020

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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