Hip health threat How to treat femoral head osteonecrosis and hip fracture?
Feb 27, 2025
The hip joint is an important joint that enables leg movement such as walking and running and distributes upper body loads. When there is a problem with the hip joint, pain is also a problem, but the quality of life is rapidly reduced due to walking disorders. The most representative is femoral head osteonecrosis, which accounts for about 70% of hip joint diseases in Korea, and is a scary disease that can cause joint function to be lost if left unattended. In addition, hip fractures caused by falls are also very dangerous for the elderly, as the aftereffects are large and the risk of death is high. We will learn more about how to protect hip health with Professor Jeon Young-soo of orthopedic surgery at Gangdong Kyunghee University Hospital.
◇The most common femoral head osteonecrosis among hip joint diseases
The hip joint refers to the hip joint located in the groin, which is the connection between the torso and legs. It is a joint formed by meeting the acetabular part of the cup-shaped pelvic bone and the femoral head, the upper part of the thigh bone. Various diseases can occur in the hip joint, but femoral head osteonecrosis, which was called bloodless necrosis of the femoral head in the past, is the most common. In Korea, it is a disease with an unusually high incidence compared to other countries.
◇Caused by blocked blood flow in the upper leg of the femur
Temoral head osteonecrosis is a disease in which the bone tissue of the femoral head, the uppermost part of the thigh bone in contact with the pelvic bone, dies. The femoral head is an area where blood circulation disorders occur more easily than other areas, and when blood flow to the femoral head is blocked, bone tissue gradually dies. As the disease progresses, the necrotic area collapses and bones fracture. At the end of the year, the hip itself can be damaged, resulting in loss of hip function.
◇ Risk factors such as excessive drinking and excessive use of steroids
The cause of the outbreak has not been clearly identified. However, risk factors include excessive drinking, excessive use of steroids, connective tissue diseases such as kidney disease and lupus, organ transplants, gout, and trauma. Especially for Koreans, drinking is known to be the main cause, and for this reason, it occurs most frequently in men in their 40s and 50s.
◇Groin pain makes it difficult to walk and to walk both legs
In the early stages of bone necrosis, like other hip diseases, there is little pain, so it is easy to leave it unattended. When bone necrosis progresses and fractures are issued, pain begins thereafter. Pain usually occurs on the groin side when walking, and may appear to the inside of the knee or thigh by the nerves around the hip joint. Pain becomes more severe in hip joint movements such as climbing stairs or jumping, and it becomes difficult for both legs.
◇ Total hip arthroplasty if the bone necrosis range is wide and the pain is severe
Artificial hip arthroplasty is considered when pain persists despite conservative treatment or when the range of bone necrosis is wide and the patient's pain is severe. Total replacement surgery is an operation that removes all broken hip joints and turns them into artificial joints. Remove the part of the hip joint with the lesion and insert an ergonomically manufactured instrument to restore the joint's motor function and eliminate pain. Recently, the life of artificial hip joints has been extended to more than 20 to 30 years by using fourth-generation ceramics that are resistant to wear on the joint surface.
◇Prevention of femoral head osteonecrosis will begin this week
Prevention of femoral head osteonecrosis is to avoid causative factors as much as possible. The best known are alcohol and steroid drugs. In practice, it is recommended to avoid excessive drinking, and the use of drugs is often unavoidable due to illness, so if you are given a high dose or long-term dose of steroids, your hip should be checked regularly. If you drink more than 5 to 6 bottles of soju a week or more than 10 years, the incidence of necrosis can increase by 10 times, so it is the best prevention method to avoid excessive drinking.
◇Fractures that threaten hip health in the elderly
Although the frequency of hip fractures in the elderly due to falls is not high, the frequency is steadily increasing with the extension of life expectancy. It is very dangerous because it is difficult to recover and the risk of death is high. If a hip fracture occurs in the elderly, the probability of death within one year after occurrence is 25%, and the mortality rate within two years is 70%. Fractures are also a problem, but as fractures make it difficult to move, muscle strength and bone strength weaken, and complications such as pressure ulcers, sepsis, and pneumonia can occur.
◇ Minimize complications with quick treatment of hip fractures
Surgical treatment is also a priority for the treatment of hip fractures. The goal of treatment is to reduce complications by allowing patients to recover and move quickly with rapid treatment. Hip joint surgery is often performed by attaching bones, and if necessary, artificial joint replacement surgery is also performed. According to the characteristics of elderly patients with many underlying diseases during surgery, it is very important to operate safely with thorough pre-examination and consultation with various medical departments.
◇ From fall prevention to hip fracture
How to avoid fractures around the hip is still not well known. You should prevent falls to prevent broken bones from falling, and take good care of your usual lifestyle to prevent fractures even if you fall. It prevents osteoporosis by taking enough calcium and vitamin D and frequently basking in the sun that promotes the production of vitamin D through outdoor activities. It is also important to refrain from alcohol that prevents bone formation and not lose muscle strength through regular exercise. In addition, dark indoor, winter icy roads are very important risk factors for falls, so it is essential to avoid them.
◇The most common femoral head osteonecrosis among hip joint diseases
The hip joint refers to the hip joint located in the groin, which is the connection between the torso and legs. It is a joint formed by meeting the acetabular part of the cup-shaped pelvic bone and the femoral head, the upper part of the thigh bone. Various diseases can occur in the hip joint, but femoral head osteonecrosis, which was called bloodless necrosis of the femoral head in the past, is the most common. In Korea, it is a disease with an unusually high incidence compared to other countries.
◇Caused by blocked blood flow in the upper leg of the femur
Temoral head osteonecrosis is a disease in which the bone tissue of the femoral head, the uppermost part of the thigh bone in contact with the pelvic bone, dies. The femoral head is an area where blood circulation disorders occur more easily than other areas, and when blood flow to the femoral head is blocked, bone tissue gradually dies. As the disease progresses, the necrotic area collapses and bones fracture. At the end of the year, the hip itself can be damaged, resulting in loss of hip function.
◇ Risk factors such as excessive drinking and excessive use of steroids
The cause of the outbreak has not been clearly identified. However, risk factors include excessive drinking, excessive use of steroids, connective tissue diseases such as kidney disease and lupus, organ transplants, gout, and trauma. Especially for Koreans, drinking is known to be the main cause, and for this reason, it occurs most frequently in men in their 40s and 50s.
◇Groin pain makes it difficult to walk and to walk both legs
In the early stages of bone necrosis, like other hip diseases, there is little pain, so it is easy to leave it unattended. When bone necrosis progresses and fractures are issued, pain begins thereafter. Pain usually occurs on the groin side when walking, and may appear to the inside of the knee or thigh by the nerves around the hip joint. Pain becomes more severe in hip joint movements such as climbing stairs or jumping, and it becomes difficult for both legs.
◇ Total hip arthroplasty if the bone necrosis range is wide and the pain is severe
Artificial hip arthroplasty is considered when pain persists despite conservative treatment or when the range of bone necrosis is wide and the patient's pain is severe. Total replacement surgery is an operation that removes all broken hip joints and turns them into artificial joints. Remove the part of the hip joint with the lesion and insert an ergonomically manufactured instrument to restore the joint's motor function and eliminate pain. Recently, the life of artificial hip joints has been extended to more than 20 to 30 years by using fourth-generation ceramics that are resistant to wear on the joint surface.
◇Prevention of femoral head osteonecrosis will begin this week
Prevention of femoral head osteonecrosis is to avoid causative factors as much as possible. The best known are alcohol and steroid drugs. In practice, it is recommended to avoid excessive drinking, and the use of drugs is often unavoidable due to illness, so if you are given a high dose or long-term dose of steroids, your hip should be checked regularly. If you drink more than 5 to 6 bottles of soju a week or more than 10 years, the incidence of necrosis can increase by 10 times, so it is the best prevention method to avoid excessive drinking.
◇Fractures that threaten hip health in the elderly
Although the frequency of hip fractures in the elderly due to falls is not high, the frequency is steadily increasing with the extension of life expectancy. It is very dangerous because it is difficult to recover and the risk of death is high. If a hip fracture occurs in the elderly, the probability of death within one year after occurrence is 25%, and the mortality rate within two years is 70%. Fractures are also a problem, but as fractures make it difficult to move, muscle strength and bone strength weaken, and complications such as pressure ulcers, sepsis, and pneumonia can occur.
◇ Minimize complications with quick treatment of hip fractures
Surgical treatment is also a priority for the treatment of hip fractures. The goal of treatment is to reduce complications by allowing patients to recover and move quickly with rapid treatment. Hip joint surgery is often performed by attaching bones, and if necessary, artificial joint replacement surgery is also performed. According to the characteristics of elderly patients with many underlying diseases during surgery, it is very important to operate safely with thorough pre-examination and consultation with various medical departments.
◇ From fall prevention to hip fracture
How to avoid fractures around the hip is still not well known. You should prevent falls to prevent broken bones from falling, and take good care of your usual lifestyle to prevent fractures even if you fall. It prevents osteoporosis by taking enough calcium and vitamin D and frequently basking in the sun that promotes the production of vitamin D through outdoor activities. It is also important to refrain from alcohol that prevents bone formation and not lose muscle strength through regular exercise. In addition, dark indoor, winter icy roads are very important risk factors for falls, so it is essential to avoid them.
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This article was translated by Naver AI translator.
