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Part of the book series: Current Histopathology ((CUHI,volume 21))

Abstract

The most common site of osteonecrosis is the femoral head due to deprivation of its blood supply, often because of a femoral neck fracture. Non-traumatic bone death is called ’idiopathic (primary) necrosis’, which may be associated with various factors49. This also occurs mostly in the femur, although the humerus, tibia and radius may likewise be affected. However, bone necrosis is rarely observed in the iliac crest, probably due to its abundant blood supply. Furthermore, osteonecrosis of non-weightbearing skeletal sites is often clinically silent and painless.

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References

References

  1. Aebi M. and Regazzoni P. (1989). Bone Transplantation. Berlin: Springer

    Book  Google Scholar 

  2. Amstutz H. C. and Carey E. J. (1966). Skeletal manifestations and treatment of Gaucher’s disease. J. Bone Jt Surg., 48A, 670

    Google Scholar 

  3. Arlot M. E., Bonjean M., Chavassieux P. M. and Neunier P. J. (1983). Bone histology in adults with aseptic necrosis of bone. J. Bone Jt Surg., 65A, 1319

    Google Scholar 

  4. Atrah H. I. (1992). Bone banks: could be held by regional transfusion centres. Brit. Med. J., 304, 68

    Article  PubMed  CAS  Google Scholar 

  5. Bevilacqua G., Abadessa A., Consolini R., Frijia M., Nardi M. and Macchia P. (1985). Bone marrow necrosis foreshadowing acute lymphoid leukemia. Amer. J. Pediatr. Hematot Oncol., 7, 228

    Article  CAS  Google Scholar 

  6. Brand R. A. and Rubin C. T. (1990). Fracture healing. McCollisterEvarts C., Surgery of the Musculoskeletal System (p. 93). New York: Churchill Livingstone

    Google Scholar 

  7. Burchardt H. (1983). The biology of bone graft repair. Clin. Orthop., 174, 28

    PubMed  Google Scholar 

  8. Charache S. and Page D. L. (1967). Infarction of bone marrow in the sickle cell disorders. Ann. Intern. Med., 67, 1195

    PubMed  CAS  Google Scholar 

  9. Conrad M. E. and Carpenter J. T. (1979). Bone marrow necrosis. Amer. J. Hematol., 7, 181

    Article  CAS  Google Scholar 

  10. Cowan J. D., Rubin R. N., Kies M. S. and Cerazo L (1980). Bone marrow necrosis. Cancer, 46, 2168

    Article  PubMed  CAS  Google Scholar 

  11. Cruess R. L. (1984). Healing of bone, tendon, and ligament. Rockwood C. A. and Green D. P., Fractures in Adults (p. 147). Philadelphia: Lippincott

    Google Scholar 

  12. Cruess R. L. and Crawshaw E. (1975). The etiology of steroid-induced avascular necrosis of bone. Clin. Orthop., 113, 178

    Article  PubMed  Google Scholar 

  13. Delaere O., Orloft S., Autrique J. C., Nyssen-Behets C., Dambrain R. and Dhem A. (1991). Long term sequelae of pelvis irradiation: histological and microradiographic study of a femoral head. Clin. Rheumatol., 10, 206

    Article  PubMed  CAS  Google Scholar 

  14. Dodds R. A., Emery R. J., Klenerman L., Chayen J. and Bitensky L. (1990). Selective depression of metabolic activities in cortical osteoblasts at the site of femoral neck fractures. Bone, 11(3), 157

    Article  PubMed  CAS  Google Scholar 

  15. Duncan J. S. and Ramsay L. E. (1984). Widespread bone infarction complicating meningococcal septicaemia and disseminated intravascular coagulation. Brit. Med. J., 288, 111

    Article  CAS  Google Scholar 

  16. Editorial. (1992). New bone? Lancet, 339, 463

    Article  Google Scholar 

  17. Eide J. (1982). Bone infarcts in bacterial endocarditis. Hum. Pathol., 13, 631

    Article  PubMed  CAS  Google Scholar 

  18. Enneking W. F. and Mindell E. R. (1991). Observations on massive retrieved human allografts. J. Bone Jt Surg., 73A, 1123

    Google Scholar 

  19. Everts C. M. and Phalen G. S. (1971). Osseous avascular necrosis associated with renal transplantation. Clin. Orthop., 78, 330

    Article  Google Scholar 

  20. Fisher D. E. and Bickel W. H. (1971). Corticosteroid-induced avascular necrosis. J. Bone Jt Surg., 53A, 859

    Google Scholar 

  21. Foss A. and Markus H. (1988). Osteolytic lesions in elderly diabetic woman. Brit. Med. J., 296. 280

    Article  CAS  Google Scholar 

  22. Friedlaender G. E. (1991). Bone allografts: the biological consequences of immunological events (Editorial). J. Bone Jt Surg., 73A(8), 119

    Google Scholar 

  23. Frisch B., Bartl R. and Goebel F.-D. (1989). Bone marrow manifestations in the acquired immune deficiency syndrome (AIDS). A study of 40 patients and review of the literature. Haematol. Rev, 3, 177

    Google Scholar 

  24. Goldberg V. M. and Stevenson S. (1990). Bone transplantation. McCollister-Evarts C., Surgery of the Muscu/oske/eta/ System (p. 11 5). New York: Churchill Livingstone

    Google Scholar 

  25. Grisso J.-A., Kelsey J. L., Strom B. L., Chiu G. Y., Maislin G., O’Brian L. A., Hoffman S. and Kaplan F. (1991). Risk factors for falls as a cause of hip fracture in women. N. Engl. J. Med., 324, 1326

    Article  PubMed  CAS  Google Scholar 

  26. Gross T. P., Jinnah R. H., Clarke H. J. and Cox Q. G. (1991). The biology of bone grafting. Orthopedics, 14, 563

    PubMed  CAS  Google Scholar 

  27. Harigaya K., Watanabe S., Watanabe Y., Kageyama K. and Nakazawa K. (1977). Multiple bone marrow necrosis and disseminated intravascular coagulation. Arch. Pathol. Lab. Med., 101, 652

    PubMed  CAS  Google Scholar 

  28. Harper P. G., Trask C. and Souhami R. L. (1984). Avascular necrosis of bone caused by combination chemotherapy without corticosteroids. Brit. Med. J., 288, 267

    Article  CAS  Google Scholar 

  29. Harrington K. D., Murray W. R., Kountz S. L. and Belzer F. O. (1971). Avascular necrosis after renal transplantation. J. Bone Jt Surg., 53A, 203

    Google Scholar 

  30. Heiple K. G., Chase S. W. and Herndon C. H. (1963). A comparative study of the healing process following different types of bone transplantation. J. Bone Jt Surg., 45A, 1593

    Google Scholar 

  31. Hiehle J. F., Kreeland J. B. and Dalinka M. K. (1991). Magnetic resonance imaging of the hip with emphasis on avascular necrosis. Rheum. Dis. Clin. N. Amer, 17, 669

    Google Scholar 

  32. Hughes R. G., Islam A., Lewis S. M. and Catovsky D. (1981). Spontaneous remission following bone marrow necrosis in chronic lymphocytic leukaemia. Clin. Lab. Haematol., 3, 173

    PubMed  CAS  Google Scholar 

  33. Lbels L. S., Alfrey A. C., Huffer W. E. and Well R. (1978). Aseptic necrosis of bone following renal transplantation. Medicine, 57. 25

    Google Scholar 

  34. James J. and Steijn-Myagkaya G. L. (1986). Death of osteocytes: electron microscopy after in vitro ischaemia. J. Bone Jt Surg., 68B, 620

    Google Scholar 

  35. Joyce M. E., Jingushi S. and Bolander M. E. (1990). Transforming growth factor-β in the regulation of fracture repair. Orthop. Clin. N. Amer, 21(1), 199

    CAS  Google Scholar 

  36. Kandel R. A., Pritzker K. P. H., Langer F. and Gross A. E. (1984). The pathologic features of massive osseous grafts. Hum. Pathol.,15, 141

    Article  PubMed  CAS  Google Scholar 

  37. Katthagen B.-D. (1986). Bone Regeneration with Bone Substitutes. Berlin: Springer

    Google Scholar 

  38. Kleerekoper M., Villanueva A. R., Stanciu J., Rao D. S. and Parfitt A. M. (1985). The role of three dimensional trabecular microstructure in the pathogenesis of vertebral compression fractures. Calcif. Tissue Int., 37, 594

    Article  PubMed  CAS  Google Scholar 

  39. Klippel J. H., Gerber L. H., Pollak L. and Decker J. L. (1979). Avascular necrosis in systemic lupus erythematodes. Amer. J. Med., 67, 83

    Article  PubMed  CAS  Google Scholar 

  40. Koszyca B., Fazzalari N. L. and Vernon-Roberts B. (1989). Trabecular microfractures: nature and distribution in the proximal femur. Clin. Orthop. Rel. Res., 244, 208

    Google Scholar 

  41. Kricun M. E. (1985). Red-yellow marrow conversion: its effect on the location of some solitary bone lesions. Skelet. Radio/., 14, 10

    Article  CAS  Google Scholar 

  42. Kundel D.. W., Brecher G., Bodey G. P. and Brittin G. M. (1964). Reticulin fibrosis and bone infarction in acute leukemia. Implication for prognosis. Blood,23, 526

    PubMed  CAS  Google Scholar 

  43. Lagier R. (1989). Case report 552: Post-traumatic remodelling of the distal tibial epiphysis: a form of aseptic osteonecrosis. Ske/et. Radiol., 18, 331

    Article  CAS  Google Scholar 

  44. Marry S. G., Bluestone R., Linenberg J. R. and Coburn J. W. (1975). Abnormalities of the musculoskeletal system in hemodialysis patients. Semin. Arthritis Rheum., 4, 321

    Article  Google Scholar 

  45. Melton L. J. (1988). Epidemiology of fractures. Riggs B. L. and Melton L. J., Osteoporosis: Etiology, Diagnosis, and Management (p. 133). New York: Raven Press

    Google Scholar 

  46. Mizuno K., Mineo K., Tachibana T., Sumi M., Matsubara T. and Hirohata K. (1990). The osteogenic potential of fracture haematoma. Subperiosteal and intramural transplantation of the haematoma. J. Bone Jt Surg., 72B, 829

    Google Scholar 

  47. Ohta Y. and Matsunaga H. (1974). Bone lesions in divers. J. Bone Jt Surg., 56B, 3

    Google Scholar 

  48. Parfitt A. M. (1987). Trabecular bone architecture in the pathogenesis and prevention of fracture. Amer. J. Med., 82(Suppl 1 B), 68

    Article  PubMed  CAS  Google Scholar 

  49. Petty W. (1986). Osteonecrosis. J. Bone Jt Surg., 68A, 1311

    Google Scholar 

  50. Phemister D. B. (1940). Changes in bones and joints resulting from interruption of circulation: non-traumatic lesions in adults with bone infarction: arthritis deformans. Arch. Surg., 41, 1455

    Article  Google Scholar 

  51. Ray R. D. (1972). Vascularisation of bone grafts and implants. Clin. Orthop., 87, 43

    PubMed  CAS  Google Scholar 

  52. Rhinelander F. W., Rouweyha M. and Milner J. C. (1971). Microvascular and histogenic responses to implantations of a porous ceramic in bone. J. Biomed. Mater. Res., 5, 81

    Article  CAS  Google Scholar 

  53. Ripamonti U. (1991). The morphogenesis of bone in replicas of porous hydroxyapatite obtained from conversion of calcium carbonate exoskeletons of coral. J. Bone Jt Surg., 73A, 692

    Google Scholar 

  54. Rowe C. N. and Naggers M. E. (1957). Bone infarcts in sickle cell anemia. Radiology, 68, 661

    PubMed  CAS  Google Scholar 

  55. Saito S., Inoue A. and Ono K. (1987). Intramedullary hemorrhage as a possible cause of avascular necrosis of the femoral head. J. Bone Jt Surg., 69B, 346

    Google Scholar 

  56. Siemsen J. K., Brook J. and Meister L. (1962). Lupus erythematosus and avascular bone necrosis: a clinical study of 3 cases and review of the literature. Arthritis Rheum.,5, 452

    Article  Google Scholar 

  57. Simmons D. J. (1985). Fracture healing perspectives. Clin. Orthop. Rel. Res.,200, 100

    Google Scholar 

  58. Soballe K., Gotfredsen, K., Brockstedt-Rasmussen H., Nielsen P. T. and Rechnagel K. (1991). Histologic analysis of a retrieved hydroxyapatite coated femoral prosthesis. Clin. Orthop.,272, 255

    PubMed  Google Scholar 

  59. Solomon L. (1991). Bone grafts (Editorial). J. Bone Jt Surg., 73B, 706

    Google Scholar 

  60. Tavassoli M. (1983). Bone marrow necrosis secondary to hyperparathyroidism. J. Miss. State Med. Assoc., 24, 39

    PubMed  CAS  Google Scholar 

  61. Taylor L. J. (1984). Multifocal avascular necrosis after short-term high-dose steroid therapy. J. Bone Jt Surg., 66B, 431

    Google Scholar 

  62. Terheggen H. G. and Lampert F. (1979). Acute bone marrow necrosis caused by streptococcal infection. Eur. J. Paed., 130, 53

    Article  CAS  Google Scholar 

  63. Thomas L. B., Forkner C. E., Frei E., Besse B. E. and Stabenau I. R. (1961). The skeletal lesions of acute leukemia. Cancer, 14, 608

    Article  PubMed  CAS  Google Scholar 

  64. Urist M. R. and Strates B. S. (1970). Bone formation in implants of partially and wholly demineralized bone matrix. Clin. Orthop., 71, 271

    PubMed  CAS  Google Scholar 

  65. Vesterby A. and Jensen O. M. (1985). Aseptic bone/bone marrow necrosis in leukaemia. Scand. J. Haematol., 35, 354

    Article  PubMed  CAS  Google Scholar 

  66. Ware H. E., Brooks A. P., Toye R. and Berney S. I. (1991). Sickle cell disease and silent avascular necrosis of the hip. J. Bone Jt Surg., 73B, 947

    Google Scholar 

  67. Zizic T. M., Hungergord D. S. and Stevens M. B. (1990). Ischemic bone necrosis in systemic lupus erythematodes: the early diagnosis of ischemic necrosis of bone. Medicine, 67, 83

    Google Scholar 

  68. The following recent review article includes a scheme for classifying the mechanisms of death of bone. The article deals mainly with non-traumatic osteonecrosis with onset in adulthood, and the pathogenic mechanisms.

    Google Scholar 

  69. Mankin H. J. (1992). Non-traumatic necrosis of bone (osteonecrosis). N. Engl. J. Med., 326, 1473

    Article  PubMed  CAS  Google Scholar 

See also

  • Sissons H, Nuovo M. A. and Steiner G. C. (1992). Pathology of osteonecrosis of the femoral head. Skel. Radiol., 21, 229

    Article  CAS  Google Scholar 

  • The following reference describes the materials used in bone grafting and a novel approach to enhance the osteogenic potential of demineralized bone.

    Google Scholar 

  • Nolan P. C., Mollan R. A. B. and Wilson D. J. (1992). Living bone grafts. Cell culture may overcome the limitations of allographs. Br. Med. J., 304, 1520

    Article  CAS  Google Scholar 

  • Continuing efforts are being made to ensure the safety of bone grafts: kühne J.-H., Bartl R., Hammer C., Refior H. J., Jansson V. and Zimmer M. (1993). Moderate heat treatment of bone allografts: Experimentalresults of osteointegration. Arch. Orthop. Trauma Surg., 112, 1

    Google Scholar 

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© 1993 R. Bartl and B. Frisch

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Bartl, R., Frisch, B. (1993). Necrosis, grafts and healing in bone. In: Biopsy of Bone in Internal Medicine: An Atlas and Sourcebook. Current Histopathology, vol 21. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-2222-1_8

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  • DOI: https://doi.org/10.1007/978-94-011-2222-1_8

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