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Hip Arthroplasty osteonecrosis

Kazuma Takashima, Takashi Sakai, Hidetoshi Hamada, Masaki Takao, Nobuhiko Sugano
BACKGROUND: Many studies have confirmed that the size and location of necrotic lesions are major factors that affect the prevalence of collapse and prognosis in patients with osteonecrosis of the femoral head (ONFH). Although several classification systems categorize and quantify ONFH, there is no agreement on which one is most useful for the purpose. QUESTIONS/PURPOSES: We compared the Steinberg, modified Kerboul, and Japanese Investigation Committee (JIC) classifications of ONFH in terms of (1) the correlation among the three different classification systems...
March 15, 2018: Clinical Orthopaedics and related Research
Hidetoshi Hamada, Masaki Takao, Takashi Sakai, Nobuhiko Sugano
PURPOSE: For successful joint preservation in osteonecrosis of the femoral head (ONFH), it is important to understand the mechanism of collapse. The purpose of this study was to investigate the initiation of subchondral fracture in ONFH by using micro-CT imaging of the whole femoral head, focusing on the three-dimensional relationship between the subchondral fracture and the bone resorption area. METHODS: A total of 40 femoral heads from 37 patients retrieved during total hip arthroplasty for stage 3A or 3B ONFH by Japanese Investigation Committee criteria were scanned using micro-CT with a 0...
March 14, 2018: International Orthopaedics
Mamoudou Sawadogo, Hamado Kafando, Salam Ouedraogo, Alexandre Stanislas Korsaga, Souleymane Ouedraogo, Sayouba Tinto, Anatole Jean Innocent Ouedraogo, Mohamed Tall, Songahir Christophe DA
Introduction: Head and neck resection of the femur was described by Girdlestone in 1928 in the treatment of coxalgia. Very invasive at the beginning, this intervention is much less so today, but the term of "Girdlestone's operation" or "Girdlestone's procedure" has remained in use. The reported results are controversial. In resource-limited countries, Girdlestone's procedure is often indicated for lack of a better one. In this context, we report the results of a series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso) with the aim of showing that this technique remains valid and can be benefit...
2018: Open Orthopaedics Journal
Matthew T Houdek, Cody C Wyles, Mark S Collins, Benjamin M Howe, Andre Terzic, Atta Behfar, Rafael J Sierra
BACKGROUND: Randomized trials have shown the benefits of injecting bone marrow-derived mesenchymal stem cells (BmMSCs) after standard hip decompression in patients with osteonecrosis of the femoral head. However, the combination of BmMSCs and platelet-rich plasma (PRP) injected into the femoral head after decompression has not been reported previously. This study reports the results in a preliminary series of patients with osteonecrosis of the femoral head treated with BmMSCs plus PRP...
February 2018: Clinical Orthopaedics and related Research
Peter Cnudde, Ola Rolfson, A John Timperley, Anne Garland, Johan Kärrholm, Göran Garellick, Szilard Nemes
BACKGROUND: Hip replacements are successful in restoring mobility, reducing pain, and improving quality of life. However, the association between THA and the potential for increased life expectancy (as expressed by mortality rate) is less clear, and any such association could well be influenced by diagnosis and patient-related, socioeconomic, and surgical factors, which have not been well studied. QUESTIONS/PURPOSES: (1) After controlling for birth year and sex, are Swedish patients who underwent THA likely to survive longer than individuals in the general population? (2) After controlling for relevant patient-related, socioeconomic/demographic factors and surgical factors, does relative survival differ across the various diagnoses for which THAs were performed in Sweden? METHODS: Data from the Swedish Hip Arthroplasty Register, linked to administrative health databases, were used for this study...
February 28, 2018: Clinical Orthopaedics and related Research
Cheng Wang, Haoye Meng, Yu Wang, Bin Zhao, Chenyang Zhao, Weijia Sun, Yun Zhu, Bingxing Han, Xueling Yuan, Ruoxi Liu, Xin Wang, Aiyuan Wang, Quanyi Guo, Jiang Peng, Shibi Lu
We explored the mechanism of early stage osteonecrotic femoral head collapse by analyzing and comparing different regions in human osteonecrotic femoral head samples. Eight osteonecrotic femoral heads (ARCO II-III) were obtained from patients undergoing total hip arthroplasty. Bone structure was observed and evaluated by micro-computed tomography (CT) scans and pathology. Osteoblast and osteoclast activities were detected by tartrate-resistant acid phosphatase, alkaline phosphatase, and immunofluorescent staining...
2018: International Journal of Biological Sciences
Kyu-Jin Cho, Kyung-Soon Park, Taek-Rim Yoon
PURPOSE: The aim of this study was to evaluate the effectiveness of our technique on further collapse of the femoral head in Association Research Circulation Osseous (ARCO) stage II, patient's functional improvements, and analyze the survival rate of the affected hip. METHODS: Between June 2007 and March 2015, 24 hips diagnosed with osteonecrosis of the femoral head (ONFH) were treated with our muscle pedicle bone grafting (MPBG) technique using anterior one-third of gluteus medius attached to the greater trochanter...
February 24, 2018: International Orthopaedics
Chahine Assi, Nadim Kheir, Camille Samaha, Pascal Kouyoumjian, Kaissar Yammine
INTRODUCTION: Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH...
2018: SICOT-J
C Mallet, A Abitan, C Vidal, L Holvoet, K Mazda, A-L Simon, B Ilharreborde
Purpose: Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods: All children with ONFH due to SCD were retrospectively reviewed...
February 1, 2018: Journal of Children's Orthopaedics
Christoph Schnurr, Anissa Loucif, Theresa Patzer, Bernd Schellen, Johannes Beckmann, Peer Eysel
INTRODUCTION: Short stems were developed as a bone-conserving alternative especially for the young hip arthroplasty patient. Patients suffering from osteonecrosis of the femoral head are frequently younger than primary arthritis patients. The outcome of short stems in these patients remains unclear. The aim of our study was to compare mid-term survival of short stems after osteonecrosis of the femoral head (ONFH) and primary arthritis. MATERIALS AND METHODS: Data on short stem implantations over a 10-year period were collected...
February 3, 2018: Archives of Orthopaedic and Trauma Surgery
Kai Xie, Yuanqing Mao, Xinhua Qu, Kerong Dai, Qingwei Jia, Zhenan Zhu, Mengning Yan
BACKGROUND: Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. METHODS: Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I-III nontraumatic ONFH, according to the Association Research Circulation Osseous (ARCO) system, were reviewed in the current retrospective study...
February 2, 2018: Journal of Orthopaedic Surgery and Research
Donghai Li, Zhouyuan Yang, Zhun Wei, Pengde Kang
This study aimed to determine whether bisphosphonates exert an effect on preventing femoral head collapse after osteonecrosis of the femoral head (ONFH) in an animal model and in clinical trials. A systematic literature search was performed for studies published up to January 2017. Twenty-three articles (16 animal studies, seven clinical trials) were included in the meta-analysis. We found that the bisphosphonate group obtained significant improvement in epiphyseal quotients (MD = 15.32; 95% CI, 9.25-21...
January 23, 2018: Scientific Reports
Kazuyuki Karasuyama, Goro Motomura, Satoshi Ikemura, Jun-Ichi Fukushi, Satoshi Hamai, Kazuhiko Sonoda, Yusuke Kubo, Takuaki Yamamoto, Yasuharu Nakashima
BACKGROUND: This study investigated the risk factors for postoperative complications requiring revision surgery within 3 years after transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). METHODS: We reviewed 127 patients (147 hips) who underwent TRO (anterior or posterior rotational osteotomy) for ONFH between January 2002 and December 2014. Two patients were lost to follow-up, and five patients with progression of femoral head collapse requiring a salvage procedure such as total hip arthroplasty within 3 years after TRO were excluded...
January 10, 2018: Journal of Orthopaedic Surgery and Research
Cemil Yildiz, Yusuf Erdem, Kenan Koca
INTRODUCTION: The aim of this study was to report the clinical and radiological outcomes for 21 patients (28 hips) treated for osteonecrosis of the femoral head using the lightbulb technique, a nonvascularised bone grafting technique. METHODS: The study group included 14 men and 7 women, with a mean age of 33.2 (range 22-50) years, presenting with avascular necrosis of the femoral head of stage 4a or earlier, according to the Steinberg classification. Patients were treated using the nonvascularised lightbulb bone grafting technique...
November 15, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The aim of this study was to determine how an ultra-short anatomic uncemented stem vs a diaphyseal filling five-eighths porous coated uncemented femoral stem (conventional stem) affects the survival of primary total hip arthroplasties in octogenarians. The current study consisted of 52 patients (55 hips) in the ultra-short stem group (mean age, 85.5±5.3 years) and 61 patients (72 hips) in the diaphyseal (conventional) stem group (mean age, 84.1±4.8 years). The predominant diagnosis was osteoarthritis, followed by osteonecrosis of the femoral head, in both groups...
November 11, 2017: Orthopedics
Salvador Fornell, Juan Ribera, Mario Mella, Andrés Carranza, David Serrano-Toledano, Gabriel Domecq
INTRODUCTION: The aim of this study was to examine whether the use of an internal electrostimulator could improve the results obtained with core decompression alone in the treatment of osteonecrosis of the femoral head. METHODS: We performed a retrospective study of 41 patients (55 hips) treated for osteonecrosis of the femoral head between 2005 and 2014. Mean follow-up time was 56 (12-108) months. We recorded 3 parameters: time to recurrence of pain, time to conversion to arthroplasty and time to radiographic failure...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Francisco J Nally, Gerardo Zanotti, Martín A Buttaro, Fernando D Dilernia, Ignacio G Mansilla, Fernando M Comba, Francisco Piccaluga
INTRODUCTION: Core decompression (CD) with or without the addition of autologous bone graft (CDBG) is currently the most widely accepted treatment for hip osteonecrosis in stages of pre-collapse. The use of bone marrow mesenchymal stem cells (CDSC) is emerging as a promising biological alternative. We sought to determine the total hip arthroplasty (THA) conversion rate for patients treated with CD, CDBG or CDSC. MATERIAL AND METHODS: Between 1996 and 2012, 97 cases were evaluated in 72 patients: 47 CD cases, 34 CDGB cases and 16 CDSC cases...
October 9, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Won-Sik Choy, Yong-Han Cha, Chung-Youb Jeon, Kyu-Sang Lee, Ha-Yong Kim
BACKGROUND: In the early days when delta ceramics were developed, there was a period of using delta ceramic liner and alumina ceramic head. Therefore, the purpose of this study is to investigate the clinical and radiological outcomes of total hip arthroplasty using delta ceramic liner on alumina ceramic head after a minimum of 10 years of follow-up and to evaluate problems of early delta ceramic liner. METHODS: Alumina on delta cementless total hip arthroplasty was performed in 92 hips (85 patients) from August 2005 to March 2007 at our hospital...
September 7, 2017: Journal of Arthroplasty
Dimitrios Dimitriou, Mmampapatla Ramokgopa, Jurek R T Pietrzak, Dick van der Jagt, Lipalo Mokete
BACKGROUND: Modern management of human immunodeficiency virus (HIV) infection has afforded patients longevity while increasing the burden of arthroplasty procedures because of the increased risk of osteonecrosis, fragility fractures, and degenerative joint disease. Early publications on hip and knee arthroplasty in HIV-positive patients reported a high risk of complications, although some more recent publications demonstrated acceptable outcomes. Despite the widespread nature of the HIV pandemic, there is a paucity of literature addressing outcomes following joint arthroplasty in infected patients...
September 2017: JBJS Reviews
Yasushi Wako, Junichi Nakamura, Michiaki Miura, Yuya Kawarai, Masahiko Sugano, Kento Nawata
BACKGROUND: The purpose of this study is to clarify interobserver and intraobserver reliabilities of the three-dimensional (3D) templating of total hip arthroplasty (THA). METHODS: We selected preoperative computed tomography from 60 hips in 46 patients (14 men and 32 women) who underwent primary THA. To evaluate interobserver and intraobserver reliability, 6 orthopedic surgeons performed 3D templating twice over a 4-week interval. We investigated intraclass correlation coefficients (ICCs) and percent agreement of component size and alignment, comparing morphological differences in the hip...
September 1, 2017: Journal of Arthroplasty
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