Vol. 15 No. 1 (2023): Arch Pub Health
Case Report

Avascular necrosis of the femoral head in patient with Lyme disease and Devic’s optic neuritis

Vilijam Velkovski
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Ilir Shabani
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Viktor Kamnar
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Antonio Gavrilovski
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Teodora Todorova
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Milena Bogojevska-Doksevska
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Danica Popovska
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Erieta Nikolikj-Dimitrova
University Clinic for Physical Medicine and Rehabilitation; Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

Published 2023-06-30

Keywords

  • avascular necrosis,
  • femoral head,
  • stem cells

How to Cite

1.
Velkovski V, Shabani I, Kamnar V, Gavrilovski A, Todorova T, Bogojevska-Doksevska M, Popovska D, Nikolikj-Dimitrova E. Avascular necrosis of the femoral head in patient with Lyme disease and Devic’s optic neuritis. Arch Pub Health [Internet]. 2023 Jun. 30 [cited 2023 Dec. 6];15(1):126-33. Available from: https://www.id-press.eu/aph/article/view/6078

Abstract

Avascular necrosis of the femoral head is a condition that leads to the collapse of the femoral head, which eventually ends in osteonecrosis of the hip head and the need for a total hip replacement. It affects patients of both sexes between 20-55 years of age. The pathogenetic cause is a progressive reduction of blood circulation which leads to destruction of the femoral head. Most often the causes are corticosteroid therapy, alcoholism, smoking, trauma, etc. Decompression of the femoral head accompanied by application of mesenchymal stem cells to the necrotic zone is a promising regenerative method of treatment. We present a case of a 20-year-old patient who was diagnosed with avascular necrosis of the femoral head of the left hip, due to a high dosage of corticosteroid therapy, with Lyme disease and Devic’s optic neuritis. Corticosteroid- induced avascular necrosis of the femoral head most commonly affects the femoral head, but other skeletal parts are not excluded. Majority of patients complain of pain with an insidious onset, which exacerbates with physical activity, and tends to worse with time. Early diagnosis and treatment arecrucial. Despite some controversy regarding the treatment of avascular necrosis of the femoral head with stem cells, the general outcomes of using stem cells appear to be positive in terms of efficacy and safety.

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