Steroid-associated osteonecrosis: Epidemiology, pathophysiology, animal model, prevention, and potential treatments (an overview)

Xie, Xin-Hui; Wang, Xin-Luan; Yang, Hui-Lin; Zhao, De-Wei; Qin, Ling

Total hip arthroplasty Total hip arthroplasty (Fig. 6) is usually used primarily for ON Stages III and IV, but occasionally also used for Stages I and II. The prognosis of joint replacement is poor in patients with idiopathic or traumatic ON, but still better as compared with SAON patients. The aetiology of ON did not normally affect the final outcome, but less favourable longterm results were found in SAON patients. Patients with femoral head ON are generally young and total hip arthroplasty is often an unfavourable choice. Joint preservation is too difficult due to large pre collapse lesions and post collapse disease, so surgical alternatives for these patients may also include limited femoral resurfacing and bipolar hemiarthroplasty. However, the most useful and common treatment is total hip arthroplasty.