Advances in Diagnosis and Treatment of Osteonecrosis of the Hip

In this issue, we present 12 reports from members of ARCO (Association Research Circulation Osseous) International, a society whose aims are “to encourage, coordinate and undertake clinical and basic research in the field of bone circulation and its disorders, in particular of osteonecrosis, to initiate and keep an international dialogue alive among bone circulation experts.”[1] This is a society of internationally renowned clinicians and basic sciences who bring their diverse perspectives to address the pathogenesis, diagnosis, and treatment of musculoskeletal disorders. A more detailed synopsis of the historical prospective of ARCO can be found in a recently published book entitled Osteonecrosis . [2]

Osteonecrosis of the hip can sometimes pose challenges to orthopaedists and other medical professionals involved in the musculoskeletal field. It is not uncommon to encounter a patient who visited multiple physicians and did not receive the correct diagnosis or care. Therefore, it is important for us to investigate the armamentarium of tools that are developed to address these challenges, for the best diagnostic tools, and treatment options. In an effort to mitigate this, multiple recent inventions, innovations, and improvements in the diagnosis and treatment of osteonecrosis of the hip have been developed.

In this issue, we describe advances in the genetic analysis of this disease and improvements in predicting collapse, as well as novel ways of measuring blood flow and circulatory dynamics in the bone tissue. Several joint preservation techniques, such as core decompression in posttraumatic patients and cell therapy in the older population, are presented. The trends of joint preservation techniques over the past several years as well as the risks associated with the conversion to total hip arthroplasty (THA) are reported. For the advanced disease (Ficat stages III and IV), several different treatment techniques are described, such as hip resurfacing, two-incision THA, and cementless modular THA. In addition, frequencies of THA performed for osteonecrosis and osteoarthritis over the past several years are reported.

We would like to thank the editors of the Journal of Hip Surgery for providing us with an opportunity to share the findings from recent research in this field. We hope this issue will provide information to further advance knowledge in this field and to promote research at helping patients with these disorders. We invite you to attend the next meeting of ARCO to be held on October 24, 2017, in Berlin, Germany (Wolf Drescher, MD, Program Chair). For anyone interested in more information about ARCO or the ARCO meeting, please contact Lynne Jones at [e-mail] or by phone at 1–410–550–4001.

• References

• 1 ARCO International Available at http://arco-intl.org/index.html
• 2 Steinberg ME, Steinberg DR. Osteonecrosis: historical perspectives. In: Koo K-H, Mont MA, Jones LC, , eds. Osteonecrosis. New York, NY: Springer-Verlag; 2014: 3-15