Acetabular avascular necrosis following high-dose steroid treatment and chemotherapy for leukemia: Computer tomography analysis of treatment with impaction bone grafting

Daud Tai Shan Chou, Mark Taylor, Markus Baker, Patrick Studer, Lucian Bogdan Solomon

    Research output: Contribution to journalArticle

    Abstract

    Avascular necrosis (AVN) of the bone is thought to be a serious complication of treatment for acute lymphoblastic leukemia (ALL). The acetabulum is an unusual area to be affected by AVN, and there are currently no reports of successful joint salvage procedures found in the literature. We present a case of a 20-year-old man with ALL who was diagnosed with debilitating AVN of both acetabula 2 years following initial diagnosis of ALL and treatment with a multi-agent chemotherapy regimen including high-dose corticosteroids. After unsuccessful treatment with bisphosphonate therapy, the acetabular AVN underwent bilateral curettage and impaction bone grafting to prevent collapse of subchondral fractures with the hope of salvaging both hip joints. Computer tomography (CT) of the AVN affected areas, pre- and post-bone impaction grafting, demonstrated healing of the subchondral fractures and a doubling of bone density that was maintained at 2 years after surgery. The patient resumed full weight-bearing at 3 months after first surgery, continues to ambulate unrestricted, and remains pain free 3 years post-surgery.

    Original languageEnglish
    Pages (from-to)147-154
    Number of pages8
    JournalSkeletal Radiology
    Volume49
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2001

    Keywords

    • Acute lymphoblastic leukemia
    • Avascular necrosis
    • Chemotherapy
    • Computer tomography
    • Corticosteroid
    • Impaction bone grafting

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