Femoral osteonecrosis: is surgical surgery necessary?

Good morning,

I have been diagnosed with a femoral osteonecrosis.

The CAT medical report reports: “bone rarefaction area in the superior-external area of the femoral head delimited by a thin hyper dense edge. No significant bone structural evidence; subchondral sclerosis in the acetabular roofs”.

Instead, the MRI scan reports: “subchondral alteration of the right femoral head, delimited by course jagged low-signal line, in turn, surrounded by spongious area oedema extended until the neck, in relation to the avascular necrosis process (II A Steinberg stage)”.

The sphericity of the femoral head/moderate articular space has been preserved; endo-articular spilling, preservation of the labral acetabular complex; preservation of the periarticular structures”.

The most probable cause has been the strong use of cortisone and chemo-radiotherapy. In June 2016, I was diagnosed with a Non-Hodgkin’s B-Lymphoma with mediastinum primitive. In December 2016, I ended the therapies and today, more than a year and a half later, the situation is excellent and lymphoma greatly reduced. However, it is almost certainly the therapy that caused osteonecrosis.

I also had more than one pleural effusion on the left side. Therefore, I underwent three thoracenteses during the last half of last year and a thoracoscopy (end of November) in order to avoid further thickening.

In view of all the above, I would like to know – in the light of this – if I need to undergo a surgical surgery or if it is possible to solve it with the hyperbaric chamber.

Are there any side-effects with my tumoral disease?



One comment on “Femoral osteonecrosis: is surgical surgery necessary?

  1. Claudia Rastelli on

    Dear Emidio,
    I’m really sorry for the problems you encountered.

    By reading your request, I see that osteonecrosis is at an earlier stage and that the femoral head sphericity is preserved. I would recommend you a cycle of HBOT that is not contraindicated with the lymphomatous pathology.

    It will be still necessary to undergo a preliminary medical visit, in particular, to examine the pulmonary condition and I suggest that you show us your last chest CT scanner, the documents concerning the recent surgeries and the medical visit reports.

    For more information, please do not hesitate to contact us at the + 39 0544 500152.
    Best regards,
    Dr Claudia Rastelli
    Degree in Medicine and Surgery at the University of Ferrara
    Subscribed to the Medical Council of Rimini, Number 2074


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