Osteonecrosis of the Femoral Head in Pediatric Cancer Patients

We reviewed the available literature and describe our own experience with management of femoral head osteonecrosis in patients with pediatric hematologic malignancies. Osteonecrosis has become a major complication lowering quality of life among survivors of pediatric leukemia and lymphoma. Periodic imaging during anticancer therapy allows for early detection of osteonecrosis. Most patients with greater than 30% femoral head involvement will require arthroplasty. More studies are desperately needed to find interventions for early stage osteonecrosis that would preserve the integrity of the articular surface. Bone-conserving surgeries are preferred in young patients in anticipation of multiple revisions needed during their expected lifespan.

Keywords: osteonecrosis, femoral head, glucocorticosteroids, core decompression, ALL, pediatric osteonecrosis