Osteonecrosis Can Occur Near a Hip After Trauma

Patients who have suffered trauma are at risk for developing numerous injuries. Those who have implants in place have already suffered trauma in the past. Their bodies have been broken down due to prior injuries, meaning that they are vulnerable to injuries from trauma, such as osteonecrosis, in the future.

Osteonecrosis is the term used to describe the death of bone cells following a traumatic injury or severe illness. Certain injuries, such as bone fractures, could lead to damage to nearby blood vessels. These blood vessels carry oxygen to tissue throughout the body, including the bone cells. If these cells are deprived of oxygen, the bone cells will start to die. Necrosis is the term given to tissue death, making osteonecrosis the death of blood cells. Osteonecrosis is a particularly high risk with femur fractures or hip fractures. If bone cells start to die, this can lead to serious complication for patients and represent a significant decrease in their overall quality of life.

A case study discussed a patient who recently had a hip resurfacing procedure performed and subsequently suffered a personal injury in an accident. This procedure is performed to give patients a greater degree of mobility while also decreasing the pain in their hip. This is a common procedure used to treat osteoarthritis. Patients who undergo this procedure have a series of x-rays performed afterward to make sure that they are healing appropriately. They also need to complete physical therapy to get used to the feel of their new hip. For the patient in question, the surgical procedure went as planned and the x-rays showed that the screws that had been put into place were in the proper location.

Four months after the surgery was completed, the patient was involved in an auto accident and suffered an impact to the hip that had recently been operated on. The patient developed a femur fracture in the neck of the femur, which had not been dislocated and was treated. The screws were placed to hold the fracture in the proper location in a surgical procedure that lasted over 14 hours. Unfortunately, 11 weeks after the surgery, the patient returned with further hip pain. Imaging showed that the screws had been dislocated and the patient required a hip replacement. Bone tissue was taken from the injury site and analyzed under a microscope for further information. When placed under the microscope, there were granulomas and fibrosis in the bone, demonstrating dead, irregular bone fragments. This is a sign that osteonecrosis had started to develop in the tissue, likely from trauma or lack of nutrients required to keep the tissue alive.

In recent years, medicine has tried to shift its focus from grand surgical procedures to procedures that can be performed quickly and safely which have a short recovery time. These procedures are less costly to patients and often have a faster recovery duration. In the world of hip injuries, one such example of a method is the hip resurfacing arthroplasty that is used to treat osteoarthritis. This is still a relatively new procedure that must be followed closely. This case demonstrates that patients who undergo this procedure and are subsequently involved in trauma have the potential to develop fractures of the femoral neck. In addition, these patients are also at risk for developing osteonecrosis from their femoral neck fracture. This would cause the patient to require a shift from the arthroplasty to a full hip implant, as the bone tissue had died. If physicians are aware of the risks of osteonecrosis developing from a femoral neck fracture after an arthroplasty, they could be able to spot these fractures and the subsequent potential complications sooner. This could allow faster treatments that intervene before osteonecrosis sets in, potentially avoiding the insertion of a hip implant.

Patients who have a hip implant have to undergo physical therapy after the procedure to increase the mobility in their hip. Hip implants have been a mainstay of treatment for patients with osteoarthritis and act as a way to restore mobility while also decreasing pain in the hip. Patients who have a hip implant must keep in mind that physical therapy will last different lengths of time for different people. Patients who are younger and more mobile often recover faster than their older counterparts. Complications following this surgical procedure include an infection of the surgical site. If an infection develops, patients could require an extended treatment with antibiotics to get rid of the disease. In some cases, the patient may need to have their hip opened up again so that treatment can be applied directly to the infected location.

Watch YouTube Video: Osteonecrosis of the Hip. This educational video provides an overview of osteonecrosis and the causes of it.

I’m Ed Smith, a Sacramento Personal Injury Lawyer. There is a risk of osteonecrosis developing from a fracture. If you or a loved one has been injured in an accident, call me for free, friendly advice at 916.921.6400 or (800) 404-5400.

I am proud to be an integral member of the Million Dollar Advocates Forum for the California region.

Please take a moment to look over our prior verdicts and settlements here.

Our past clients have left some informative reviews that can be seen on Avvo, Yelp, and Google.

Image Attribution: Image was copied from Wikimedia Commons with permission from the CC BY SA License, version 3.0.

:dr cha [cs 941]