[A case report of male alcoholics treated the left replacement prosthesis on account of the idiopathic avascular necrosis of the left femoral head].

Idiopathic necrosis of the femoral head is already described associated with alcoholism. However, it is unusual to meet alcoholic patient with idiopathic necrosis of the femoral head in psychiatric hospital. In this report, we describe about the psychiatric treatment of an alcoholic male patient who complicated idiopathic necrosis of the femoral head. He begun drinking a large amount of alcohol at the age of 20. After 32 years old, he repeated admission to psychiatric hospitals for the treatment against alcohol dependence. At the age of 35, he felt left hip pain. At 36 years old, the illness was diagnosed as idiopathic necrosis of the femoral head and osteotomy was performed. After the operation, he did not keep the direction to keep a rest and not to drink. At last, total replacement arthroplasty was undergone. All through the treatment, we supported the patient to participate in group therapy and Alcoholics Anonymous, and approached directively and supportively to gain an insight about problems of drinking. As a result, after the last operation he hoped psychiatric treatment of his own will and began to gain insight gradually about his own alcoholic problems. This case emphasizes the necessity of psychotherapeutic approach and treatment programs for alcohol dependence and its physical complications.