Instructional Course Lecture   |    
Osteonecrosis of the Hip: Management in the Twenty-first Century
Jay R. Lieberman, MD; Daniel J. Berry, MD; Michael A. Montv, MD; Roy K. Aaron, MD; John J. Callaghan, MD; Amar Rayadhyaksha, MD; James R. Urbaniak, MD
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An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

Jay R. Lieberman, MD
Department of Orthopaedic Surgery, University of California at Los Angeles Medical Center, 10833 LeConte Avenue, 76-134 CHS, Los Angeles, CA 90095

Daniel J. Berry, MD
Mayo Clinic, 200 First Street S.W., Rochester, MN 55905

Roy K. Aaron, MD
100 Butler Drive, Providence, RI 02906

Michael A. Mont, MD
2401 West Belvedere Avenue, Baltimore, MD 21215

John J. Callaghan, MD
University of Iowa Health Care, 200 Hawkins Drive, Iowa City, IA 52242

Amar Rayadhyaksha, MD
2401 West Belvedere Avenue, Baltimore, MD 21215

James R. Urbaniak, MD
Division of Orthopaedic Surgery, Department of Surgery, Duke University Medical Center, Box 2912, Durham, NC 27710

Printed with the permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2003 in Instructional Course Lectures, Volume 52. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits from a commercial entity. A commercial entity (DePuy, a Johnson and Johnson company) paid or directed, or agreed to pay or diret, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which one of the authors (D.J.B.) is affiliated or associated.

J Bone Joint Surg Am, 2002 May 01;84(5):834-853
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Osteonecrosis, also known as avascular necrosis or aseptic necrosis, is a disease of impaired osseous blood flow. The term aseptic necrosis had been commonly used in the past to distinguish osteonecrosis related to nonseptic causes from that related to septic causes. It commonly affects patients in the third, fourth, or fifth decade of life. Three hundred thousand to six hundred thousand people have osteonecrosis of the femoral head in the United States. The development of osteonecrosis can have a major impact on an individual's lifestyle. Since so many of the patients are young when they are diagnosed, they often need to alter their work and leisure activities. The ultimate goal of treating osteonecrosis of the hip is preservation of the femoral head. However, this is difficult since the condition is associated with a number of different diseases and neither the etiology nor the natural history has been definitively determined. The diagnosis of osteonecrosis accounts for 5% to 12% of total hip replacements performed 1 .
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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