Interruption of the blood flow may occur in intraosseous arteries within the femoral head. We report a 72-year-old woman who developed osteonecrosis of the femoral head 11 months after surgery involving massive cementing of a segmental distal femoral rotating hinge prosthesis to treat nonunion of the distal femur. The bone cement filled the cavity up to the femoral neck and the superolateral portion of the femoral head, blocking the bone marrow.
AtsumiTKurokiY. Role of impairment of blood supply of the femoral head in the pathogenesis of idiopathic osteonecrosis. Clin Orthop Relat Res1992;277:22–30.
2.
HungerfordDS. Pathogenetic considerations in ischemic necrosis of bone. Can J Surg1981;24:583–7.
3.
WangGJSweetDERegerSIThompsonRC. Fat-cell changes as a mechanism of avascular necrosis of the femoral head in cortisone-treated rabbits. J Bone Joint Surg Am1977;59:729–35.
4.
ZizicTMMarcouxCHungerfordDSStevensMB. The early diagnosis of ischemic necrosis of bone. Arthritis Rheum1986;29:1177–86.
5.
OhzonoKTakaokaKSaitoSSaitoMMatsuiMOnoK. Intraosseous arterial architecture in nontraumatic avascular necrosis of the femoral head. Microangiographic and histologic study. Clin Orthop Relat Res1992;277:79–88.
6.
FisherDE. The role of fat embolism in the etiology of corticosteroid-induced avascular necrosis: Clinical and experimental results. Clin Orthop Relat Res1978;130:68–80.
7.
JonesJPJr. Fat embolism and osteonecrosis. Orthop Clin North Am1985;16:595–633.
8.
WangTYAvlonitisEGRelkinR. Systemic necrotizing vasculitis causing bone necrosis. Am J Med1988;84:1085–6.
9.
Van VeldhuizenPJNeffJMurpheyMDBodensteinerDSkikneBS. Decreased fibrinolytic potential in patients with idiopathic avascular necrosis and transient osteoporosis of the hip. Am J Hematol1993;44:243–8.
10.
HorneJGBruceWDevanePATeohHH. The effect of different cement insertion techniques on the bone-cement interface. J Arthroplasty2002;17:579–83.
