Femoral head osteonecrosis and substance abuse: Introduction: Femoral head osteonecrosis (FHON) is a progressive disease with a natural history of two years. The most effective treatment option for majority of cases is total hip replacement (THR). Despite wide spread ongoing research, three is no consensus for treatment of FHON. Up to 15% of all annual hip replacement in the United States are performed due to FHON. Dubstance abuse: Several studies and reports had shown relation between intravenous substance abuse and FHON. Illegal forms of buprenorphine and heroin combined with corticosteroids are responsible for these conditions. Thrombophlebitis among IV drug users is a well-known problem, it seems that repetitive intra femoral vein injection of drugs leads to FHON. Conclusion: It might not possible to prevent such hereditary and genetic etiologies of FHON, but improving health literacy in community and awareness of physicians and health care professionals could decrease the preventable steroids and consumption and decrease the incidence of FHON.
