Non-traumatic osteonecrosis of femoral head and its association with cardio-vascular disease: a case control study

Abstract Introduction Many parallels have been drawn in the past between the ischaemic process in the femoral head and in other organs like the heart (myocardial ischemia) and brain (stroke) suggesting similarities in their etio-pathogenesis. We aimed to study the relationship between coronary heart disease after non-traumatic osteonecrosis of femoral head (ONFH) by assessing the cardio-vascular profile utilizing non-invasive methods. Methods A case-control study was conducted at a tertiary care hospital to determine the association between non-traumatic ONFH and cardio-vascular pathology using non-invasive methods that assessed intravascular (lipid profile), microvascular (retinal fundoscopy) and macrovascular (ophthalmic and carotid doppler) parameters. Results 48 patients were analysed, which comprised 24 cases and 24 controls, with each group consisting of 16 males and 8 females. Mean age of cases and controls were 37.08 ± 11.81 and 37.25 ± 11.67. Steroid intake (45.83%) was the most common predisposing factor, followed by chronic alcohol intake(25%). The ophthalmic and carotid artery doppler and lipid profile measurements did not find any statistically significant difference between the cases and controls. Fundus examination revealed C/D ratio of <0.3, foveal reflex and normal optic disc in all cases. Conclusion Though it is believed that non-traumatic osteonecrosis of the femoral head precedes the development of coronary artery disease, our study did not identify any significant relationship between the two when assessed by colour doppler of the ophthalmic and carotid arteries. The lipid profile characteristics of cases and controls showed no statistically significant variation.