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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2013, Número 4

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Acta Ortop Mex 2013; 27 (4)


Revisión del tratamiento no quirúrgico de la necrosis aséptica de la cabeza femoral

Gómez-García F

Idioma: Español
Referencias bibliográficas: 65
Paginas: 265-272
Archivo PDF: 212.33 Kb.


RESUMEN

La necrosis aséptica de la cabeza femoral es un padecimiento frecuente que se manifiesta en forma insidiosa y en sus inicios es asintomática, por lo que a menudo no se diagnostica en fases tempranas. El objetivo de esta revisión es actualizar el estado que guarda el diagnóstico y tratamiento no quirúrgico de la necrosis aséptica de la cabeza femoral. Se analiza la historia natural de la enfermedad, así como la importancia pronóstica del diagnóstico temprano y de la identificación de la extensión y localización de osteonecrosis. Se discuten los diferentes métodos de tratamiento no quirúrgicos como son: las ondas de choque extracorpóreas de alta energía, los campos pulsátiles electromagnéticos, los tratamientos con oxígeno hiperbárico, los fármacos, la fisioterapia y la medicina regenerativa. Se concluye que ningún método es útil en etapas avanzadas y que existen grandes esperanzas de tratar esta enfermedad sin cirugía, pero se tiene que avanzar en investigación sobre todo en los campos de aplicación de agentes biofísicos externos y en la medicina regenerativa. El estándar de oro para su tratamiento sigue siendo la descompresión quirúrgica de la cabeza femoral en etapas donde aún no hay colapso, con una aparente mejoría en el pronóstico cuando se emplean auxiliares biofísicos y de medicina regenerativa.


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