Vol - 29, Issue - 06
About the Journal
[This article belongs to Volume - 29, Issue - 06]
International Medical Journal
Journal ID : IMJ-26-05-2022-1457
Total View : 361

Abstract : Avascular necrosis of the femoral head occurs when blood flow to the femoral head is partially or irrevocably altered. The absence of blood supply causes the bone marrow and bone cells to die, followed by the breakdown of the bone structure, resulting in the destruction of bony architecture, local soreness, and reduction of hip joint efficiency. Avascular necrosis of the femoral head is now classified and described using over 16 distinct categorization systems. The management for cases of avascular necrosis femoral head is directly going for surgery after making the diagnosis clinically and radiologically. Histological examination is often not done as it is considered waste of time and money. We conducted this study to realise the importance of histopathological features of avascular necrosis to make sure that for staging and further management, histopathology is also given its due importance. Purpose of this study is to provide a current perspective of non-traumatic AVN of femoral head based on comprehensive histopathological analysis and provide histopathological typing. In our study, we had taken 40 patients admitted to AVBRH Orthopaedics department with diagnosis of non-traumatic avascular necrosis of femoral head. Bone Biopsy samples were obtained from femoral head in patients undergoing core decompression or total hip replacement procedure. Biopsy samples were then processed for histopathological examination. Under microscope, examination of the samples were carried out once processed. Histopathological findings were then analyzed and common features were identified. Based on the features seen on microscopy, typing was done into 4 groups and classification system was proposed. In our study, we found that patients diagnosed with Non-traumatic AVN had significant changes occurring in femoral head on microscopy. Examination of these histopathological features and typing them can provide the severity of the disease and also help in plan of management accordingly. Hence, classifying and typing of histopathologic features becomes an important tool in management of Avascular necrosis. There were 12 classical features seen on histology. All these features were grouped on the basis of increasing severity. A novel Histopathological typing system was made.

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