Moon JG, Shetty GM, Biswal S, Shyam AK, Shon WY. Alcohol-induced multifocal osteonecrosis: a case report with 14-year follow-up.
Arch Orthop Trauma Surg 2008;
128:1149-52. [PMID:
18196253 DOI:
10.1007/s00402-007-0563-9]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Indexed: 12/01/2022]
Abstract
Alcohol-induced osteonecrosis of femoral head is common but multifocal osteonecrosis secondary to alcohol is very rare. The authors report one case of multifocal alcohol-induced osteonecrosis involving both hips and both knees and its subsequent progression and management over a period of 14 years. There was bilateral involvement of hips in pre-collapse stage for which a core decompression was done. The left hip responded well and at 14-year follow-up was asymptomatic with full range of motion. The core decompression surgery failed in the right hip within 1 year and subsequently hybrid total hip replacement arthroplasty was done with good functional results at 13 years follow-up. The diagnosis of knee osteonecrosis was most probably missed initially and was subsequently diagnosed 6 months back due to symptoms of pain and radiographic findings for which a core decompression was done with good early results. The results of treatment of hip was excellent in our patient and despite the rarity, a high degree of suspicion and regular screening is necessary to detect involvement of other areas like the knee in alcohol-induced osteonecrosis.
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