Association of constitutional thrombophilic risk factors in aseptic osteonecrosis of femoral heads and thromboembolic disease : case report

Abstract

Aseptic non-traumatic osteonecrosis of femoral heads is a com-plex pathology, resulting in the destruction of the hip in adult. Its etiopatho-genesis is multifactorial. Constitutional and acquired thrombophilia and hypofibrinolysis states have been postulated to be causative of this disease. We describe the case of a 42 - years - old man who developed bilateral asep-tic osteonecrosis of femoral head with thromboembolic events. Among biolo-gical investigations, protein C deficiency, activated protein C resistance asso-ciated with heterozygous factor V Leiden mutation and heterozygous G20210A prothrombin gene mutations were performed. This patient was thought to have systemic thromboembolism because of the increased blood coagulability resulting from the presence of these thrombophilic risk factors. This raises the possibility that thrombophilia is a contributing factor to the development of osteonecrosis. Related investigations should be performed and appropriate anticoagulant therapy started.