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1. What Causes the Hip Joint to Collapse
First a little anatomy: The hip joint is a ball and socket joint consisting of two bones. The thigh bone, or femur, forms the ball, and the pelvis forms the socket.
Without good blood flow to carry nutrients to the joint, the hip joint collapses.
血流が悪くて栄養が行かないから
This condition is called osteonecrosis 大腿骨骨頭の骨壊死 of the femoral head, in which the ball portion of the joint is starved for blood, and collapses.
(Another common name for this condition is avascular necrosis of the femoral head.)
別名 大腿骨頭の無血管性壊死
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2. Consuming Alcohol
過度の飲酒
Excessive alcohol use is a common cause for collapse of the femoral head. Alcohol damages the blood vessels and the micro-architecture of the bone, leading to eventual damage to the hip joint. Patients can prevent further damage to their hips by limiting their use of alcohol.
適量にしとけ、
だって。
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3. Taking Steroids
薬の副作用
高容量のステロイド剤
High dose steroids are a common medication used to control an inflammatory disease, such as asthma, rheumatoid arthritis, or autoimmune disorder. Unfortunately, the steroid can lead to increased amounts of fatty cells within the femoral head, which ultimately impacts the blood supply. While some patients may be able to control their inflammatory diseases with other medications or lifestyle changes, many will have to continue their steroid medication to keep these processes at bay. Some of these patients may eventually require a total hip replacement.
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4. Sustaining Trauma
持続するトラウマ
トラウマって？
と思ってたら 衝撃による外傷 のことでした。
つまり 骨折とか脱臼とかで 血管が傷ついたことによって
栄養を運べないから壊死になっちゃうんだね。
A high impact trauma to the hip, such as a fracture or hip dislocation, can injure the blood vessels which provide nutrients to the hip joint. Sometimes, the injury is so severe that the body's natural healing mechanisms are not adequate to repair the blood vessel damage, and these patients develop avascular necrosis of the femoral head. In these instances, in which there was trauma to the hip, there is a high risk that the ball portion (femoral head) will collapse.
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5. Having Diabetes
健康上の理由として 糖尿病 が考えられる。
Those with diabetes have trouble with circulation, because diabetes causes blood vessels to become fragile and easily damaged. In diabetes, the small vessels which supply nutrients to the hip joint may fail to deliver enough nutrients to the hip, and eventually the hip joint can collapse. Patients with diabetes can protect their hip joints by controlling their blood sugars and eating a diabetic diet.
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6. Being Diagnosed With a Blood Disorder
血液障害（血栓とか日本人にはあんまりいない鎌状赤血球症）
鎌状赤血球症：
遺伝性の貧血病で赤血球の形状が鎌状になり酸素運搬機能が低下して起こる貧血症。
鎌状赤血球貧血症ともいう。
ICD-10分類ではD57。
ほとんどが黒人に発症し主にアフリカ、地中海沿岸、中近東、インド北部で見られる。
Many patients suffer from blood disorders that effect the fluidity of blood (such as blood clots or sickle cell disease) which can lead to damage of the vessels which supply blood to the hip joint. When these vessels become clogged or clotted off, the blood supply to the ball (the femoral head) becomes damaged, which can cause the ball to collapse. Patients with blood disorders may be able to prevent some of this damage by staying well hydrated 脱水症状にならないようにすれば防げる かも？.
In many of these cases, once the blood supply to the hip is injured, the body is not able to naturally heal the blood supply on its own. Without intervention, there is a high likelihood that the hip will collapse.
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7. Keep Hips Healthy and Prevent Collapse With Stem Cells
エール大学の幹細胞治療があるよ！
ステムセルで新しい血管を股関節に作って栄養を送る。
Osteonecrosis of the femoral head is being treated with stem cell treatments.
In a new procedure performed at Yale School of Medicine's academic medical practice, Yale Medicine, stem cells are being taken from the patient's pelvis (from bone marrow) and placed into the hip joint. The stem cells help new vessels grow into the hip joint to provide nourishment. This therapy can prevent the femoral head from collapsing.
The process of sampling the bone marrow, called harvesting, is conducted through a small minimally invasive procedure. The surgeon then processes the bone marrow to isolate the stem cells, which are special cells within a patient's bone marrow that have the ability to regrow blood vessels and repair the hip joint.
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8. When the Hip Collapses: Total Hip Replacement
手遅れの場合には人工股関節置換術。
これは20年ほどしかもたないから、また、やり直さないといけないかも知れないから
股関節が痛むなら早いところ医者に相談を。
Unfortunately, if the damage to the hip joint is caught too late, the hip may have already collapsed. In those instances, patients will require a total hip replacement. This procedure is when the damaged hip is replaced by metal, plastic and ceramic materials.
While patients are able to return to their normal activities after total hip replacement, the medical device has a limited lifespan for approximately 20 years, and the patient may eventually require additional procedures. That's why it's very important to try to avoid hip problems – and catch them early. So if you're experiencing hip pain now, see your doctor and get it checked out.
Daniel Wiznia, MD, is an orthopaedic specialist at Yale Medicine and assistant professor of Orthopaedics and Rehabilitation at Yale School of Medicine. He focuses on developing novel stem cell treatments for osteonecrosis of the femoral head. He is an innovator of robotic total hip replacement and total knee replacement.
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