Duration of femoral head necrosis
The course of a femoral head necrosis can vary greatly from person to person. During stages 0 and 1, sudden self-healing is possible, so the duration of the disease is short. In most cases, femoral head necrosis progresses and deforms the femoral head considerably. Without therapy, it takes about two years until the femoral head collapses and the hip joint is completely destroyed.
How long is one incapacitated with femoral head necrosis?
As already described in the definition, femoral head necrosis is caused by a lack of blood supply to the femoral head, medically called ischemia. In this context, it must be said that, anatomically speaking, the blood supply to the femoral head is generally considered critical. The femoral head is supplied with blood from the femoral neck via an individually created artery.
Due to the individually created arterial supply, a so-called “underdevelopment” of the arterial supply to the femoral head is seen as the cause and decisive factor in the course of the disease. A distinction is made in the area of femoral head necrosis between:
- The primary (idiopathic) femoral head necrosis and
- Secondary necrosis of the femoral head
While primary femoral head necrosis is not associated with any accompanying or underlying disease and, apart from the frequent occurrence of the disease on both sides, only an increased incidence of the male sex between the ages of 35 and 45 can be detected, direct connections with other diseases are known in the area of secondary femoral head necrosis. In both subtypes, however, cause and causality are largely unknown.
Primary (idiopathic) femoral head necrosisMen between 35 and 45 years of age are typically affected by this form of femoral head necrosis. The disease is often not limited to one femoral head. This and the fact that the disease usually occurs during the period of greatest (professional) performance explains the often heavy psychological and social burden on the patient.
Secondary femoral head necrosisMan assumes a direct connection with other diseases. The underlying causes are complex and can be found in the following diseases. known causes:
- Hip joint injuries of various types (e.g. femoral neck fracture)
- Sickle cell anemia (genetically determined, inherited blood disease)
- Caisson disease (= a decompression sickness that occurs when there is a rapid drop in pressure or when staying at altitude, also called Diving sickness or compressed air sickness.
Nitrogen bubbles are formed in the vascular system and as a result, there is a circulatory disorder)
- Gaucher’s disease (hereditary sugar metabolism disease, which can lead to organ enlargement, among other things)
- Lupus erythematosus (autoimmune disease affecting the heart, liver, kidney and joints)
- More information on this topic is available at: Lupus erythematosus
- Vascular diseases (e.g. thrombosis)
- Connective Tissue Diseases
- Cortisone therapy (both as local joint injection and as systemic therapy)
- Irradiation of the pelvic area
- Cytostatic therapy (for tumor diseases)
- Rheumatic diseases
- Unfavorable living habits, such as alcohol abuse
A fracture of the femoral neck is a common cause of the development of femoral head necrosis at an advanced age. The neck of the femur typically fractures as a result of an accident, often as part of a fall. In addition to the bone fracture, femoral head vessels can be damaged, which run in the femoral neck close to the femoral head.
This can lead to tissue death in the area of the femoral head. This is known as post-traumatic femoral head necrosis. The picture on the left shows a disturbed blood supply of the femoral head in an animal. While the neck of the femur appears to be vital and well supplied with blood, no blood supply can be detected in the upper part of the femoral head. From a medical point of view, this “dead” area is referred to as necrotic or avital.