Five cases of corticosteroid-induced avascular necrosis of femoral head which were experienced at the Department of Orthopaedic Surgery, Catholic Medical College, are reported with review of literature.
All patients received corticosteroids for the treatment of rheumatoid arthritis.
Prednisolone was the most common drug used, having been given to 3 patients. Two patients has received Dexacortisil alone or in combination with other corticosteroids.
There was a considerable variation in the dosage, but in every case the dosage was in excess of physiological replacement. The total dosage administered in each patient was impossible to determine with any degree of accuracy. The duration of corticosteroid treatment varied. The shortest known period of treatment in this series was 12 months, the longest 60 months.
The avascular necrosis noted in the eight femoral heads was treated conservatively in three and surgically in five. As a whole, metallic pinning in two cases, associating the fracture of the neck, cup arthroplasty in one and Austin-Moore hip prosthesis in two cases were performed. Five hips restored satisfactory range of motions, despite of the types of surgery.
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