Femoral head necrosis

Synonyms in a broader sense

ideopathic aseptic femoral head necrosis, HKN

Definition

Necrosis of the femoral head is the term used to describe all acquired diseases in the area of the femoral head which lead to the death of areas of the femoral head and/or the entire femoral head as a result of a deficiency in blood flow to the femoral head (= ischemia). Necrosis of the femoral head usually develops in adulthood as a complication after treatment of a congenital or traumatic hip joint luxation, femoral neck or pelvic fractures. It leads to a restriction of movement and to severe, interval-like pain. The final stage of a femoral head necrosis can be the so-called coxarthrosis (hip joint arthrosis).

Hip Pain

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Age

mostly between the age of 35 and 45

Gender distribution

male > female, up to 50% also on both sides

Frequency

Occurrence approx. 1:1000 – 1:5000

Symptoms of femoral head necrosis

The symptoms of femoral head necrosis are similar in most patients, which is why the disease can often be inferred from the symptoms. Nevertheless, the symptoms of femoral head necrosis are often very unspecific and can easily be overlooked. On the one hand, hip necrosis occurs more frequently in children.

In this case, a load-dependent pain in the hip joint and in the knee joint occurs. Since the pain occurs mainly when the child should and must move, the symptoms are often misinterpreted and not perceived as symptoms of femoral head necrosis, but rather as laziness. It is therefore important to pay attention to whether a previously active child suddenly no longer feels like running around or doing sports.

In adults, the symptoms of femoral head necrosis are similar. There is also a load-dependent pain either in the hip or in the knee joint. In most cases, the pain occurs on only one side, namely on the side where the femoral head necrosis also occurs.

In addition, femoral head necrosis leads to the symptom of a difference in leg length, whereby the patient often notices that they are slightly crooked or that one leg must be more strongly angled than the other when sitting. In general, however, the symptoms of femoral head necrosis are very unspecific and can therefore easily be overlooked. Therefore, attention should be paid to any signs such as a slight pulling in the groin area or sudden pain.

In addition, the patient should pay attention to whether he or she can manage normal hip movements in everyday life without problems or whether he or she feels pain during various movements, as these too can be symptoms of femoral head necrosis. A femoral head necrosis often causes sudden, severe pain in the groin area. The shooting pains typically occur at night and at rest.

The mobility of the hip is severely restricted. Those affected have great difficulty turning or stretching the leg of the affected hip joint inwards. It is not uncommon for sufferers to report pain in the knee joint. This can be one reason why hip necrosis is sometimes misinterpreted and is only diagnosed late. Because of the pain, the affected persons take a typical relieving posture, a so-called “pain hip”.