Postoperative AP pelvis X-ray showing cementless right total hip replacement after AVN

A 40-year-old male patient presented with advanced right hip avascular necrosis, with radiographic features of femoral head collapse and secondary degenerative hip changes. After clinical evaluation and radiographic assessment, cementless total hip replacement was performed.

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Medical note: This anonymized case is shown for educational purposes only and does not replace individualized medical assessment, imaging review, or clinical examination.

Case summary

Age and sex40-year-old male.
DiagnosisAdvanced right femoral head avascular necrosis.
Preoperative problemFemoral head collapse and deformity with loss of joint congruity.
ProcedureRight cementless total hip replacement / total hip arthroplasty.
CategoryCase Library / Hip Replacement / Avascular Necrosis.
Reconstruction goalJoint reconstruction and restoration of hip mechanics according to the case requirements.

Patient-facing explanation

Avascular necrosis of the femoral head occurs when the blood supply to part of the hip ball is compromised. Early stages may be managed with joint-preserving options in selected patients. In advanced stages, when the femoral head has collapsed and the hip joint is damaged, total hip replacement can become an appropriate reconstructive option.

Why total hip replacement was selected

When femoral head collapse and joint-surface damage are advanced, joint-preserving surgery may no longer be appropriate. The objective is to replace the damaged femoral head and acetabular bearing surface while restoring hip offset, limb mechanics, and functional mobility as safely as possible.

What cementless fixation means

Cementless implants are designed to achieve biological fixation through bone ingrowth. This option may be suitable in selected younger adults with adequate bone quality, but implant choice must always be individualized.

Radiographic documentation

The following radiographs are included for educational and website case-library use. Patient-identifying details are intentionally omitted.

Preoperative AP pelvis X-ray showing advanced right femoral head avascular necrosis with collapse
Figure 1. Preoperative AP pelvis radiograph showing advanced right femoral head AVN with collapse and secondary degenerative changes.
Postoperative AP pelvis X-ray showing cementless right total hip replacement after AVN
Figure 2. Postoperative AP pelvis radiograph after right cementless total hip arthroplasty.

When hip pain needs specialist assessment

  • Persistent groin pain or hip stiffness in a younger adult.
  • Progressive limitation of walking or weight-bearing.
  • X-ray or MRI report suggesting femoral head AVN or collapse.
  • Increasing pain despite conservative treatment.
Related pages: Learn more about joint replacement surgery or request a second opinion if you already have imaging and reports.

FAQ

Does every AVN case need hip replacement?

No. Early AVN may be suitable for joint-preserving options. Hip replacement is usually considered when collapse or secondary arthritis makes preservation unreliable.

Is MRI useful in avascular necrosis of the femoral head?

Yes. MRI is more sensitive in early AVN, while plain X-ray changes become clearer after femoral head collapse.

What does cementless hip replacement mean?

Cementless implants are designed for biological fixation through bone ingrowth. They are selected when patient factors and bone quality are suitable.

Does this case guarantee the same result for every patient?

No. This is an educational case only. Treatment and recovery depend on AVN stage, bone quality, activity level, general health, and clinical assessment.

Medical disclaimer: This case is presented for educational purposes only. It does not replace individualized medical consultation, examination, or review of complete imaging and medical history.

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