Avascular necrosis (AVN) of the bone is thought to be a serious complication of treatment for acute lymphoblastic leukemia (ALL). The acetabulum is an unusual area to be affected by AVN, and there are currently no reports of successful joint salvage procedures found in the literature. We present a case of a 20-year-old man with ALL who was diagnosed with debilitating AVN of both acetabula 2 years following initial diagnosis of ALL and treatment with a multi-agent chemotherapy regimen including high-dose corticosteroids. After unsuccessful treatment with bisphosphonate therapy, the acetabular AVN underwent bilateral curettage and impaction bone grafting to prevent collapse of subchondral fractures with the hope of salvaging both hip joints. Computer tomography (CT) of the AVN affected areas, pre- and post-bone impaction grafting, demonstrated healing of the subchondral fractures and a doubling of bone density that was maintained at 2 years after surgery. The patient resumed full weight-bearing at 3 months after first surgery, continues to ambulate unrestricted, and remains pain free 3 years post-surgery.

中文翻译：

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大剂量类固醇治疗和白血病化疗后的髋臼无血管坏死：撞击式植骨治疗的计算机断层扫描分析。

骨骼的无血管坏死（AVN）被认为是急性淋巴细胞白血病（ALL）的严重治疗并发症。髋臼是受AVN影响的异常区域，目前在文献中没有成功的联合抢救程序的报道。我们提出了一例20岁男性ALL的病例，该患者在ALL的最初诊断后2年被诊断出髋臼AVN衰竭，并接受了包括高剂量皮质类固醇在内的多药物化疗方案的治疗。在使用双膦酸盐治疗失败后，髋臼AVN进行了双侧刮宫和植骨术，以防止软骨下骨折的塌陷，希望挽救两个髋关节。AVN受影响区域的计算机断层扫描（CT），骨前和骨后植骨，证实了软骨下骨折的愈合，并且在术后2年保持了骨密度的翻倍。首次手术后3个月，患者恢复了完全负重，继续不受限制地行走，并且术后3年无疼痛。