Osteonecrosis: Historical Perspective

Osteonecrosis, also known as avascular necrosis, ischemic necrosis, and aseptic necrosis, is not a specific disease entity. It is rather a condition in which a circumscribed area of bone becomes necrotic as a result of the loss of its blood supply. This chapter will attempt to provide a historical perspective on osteonecrosis, starting with the earliest case reports and extending to the present. It will focus on specific developments in regard to etiology and pathogenesis, diagnosis, classification, and management. It will end with some suggested goals for the future. Discussion will essentially be limited to nontraumatic osteonecrosis in the adult and will emphasize the hip since this joint is the region most frequently affected and the one which has been studied most extensively.