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Arthroplasty osteonecrosis

Mohamed Zubair Farook, Moji Awogbade, Karthik Somasundaram, Ines L H Reichert, Patrick L S Li
BACKGROUND: Sickle cell disease (SCD) is a multisystem disease, and the predominant articular manifestation is osteonecrosis (ON). Total hip arthroplasty (THA) is technically challenging, and the complication rates are high. In this retrospective study, we have analysed the outcome of THA in a cohort of patients with SCD at our institution. MATERIALS AND METHODS: We identified 34 THAs between 1999 and 2016 in 30 patients (mean age 37 years) from our SCD database...
June 15, 2018: International Orthopaedics
Hyeon Jun Kim, Sung Soo Kim, Su Jin Kim, Kyung Ho Lee
The diagnostic criteria for sequential rapidly destructive coxarthrosis remain unclear and this condition is rarely reported in patients with human immunodeficiency virus (HIV). Here, we report a case of an HIV-infected 73-year old female who experienced hip joint destruction. The patient was diagnosed with HIV in 2012 (at age 68 years) and began continuous treatment with nucleoside reverse transcriptase and protease inhibitors. Twenty-nine months after her HIV diagnosis, the patient experienced osteonecrosis of the right hip and underwent a total hip arthroplasty (THA)...
June 2018: Hip & Pelvis
Ana Lucia L Munhoz Lima, Priscila Rosalba Oliveira, Vladimir C Carvalho, Alexandre Leme Godoy-Santos, Leandro Ejnisman, Claudia R Oliveira, David E Uip, Maria Irma S Duarte
Objective: To examine the presence of HIV in bone tissue of people living with HIV (PLWHIV) with osteonecrosis of femoral head and describe clinical and anatomopathological findings. Design: This is a case series which included 44 PLWHIV with osteonecrosis of femoral head who underwent total hip arthroplasty. Methods: Clinical data were obtained through analysis of the patients' medical records. Bone tissue obtained during total hip arthroplasty was retrieved and sent for conventional and immunohistochemical analysis...
2018: HIV/AIDS: Research and Palliative Care
Ao Wang, Ming Ren, Jincheng Wang
Steroid (glucocorticoid)-induced osteonecrosis of the femoral head (SONFH) is a metabolic disease that occurs due to the use of glucocorticoid drugs, leading to impaired blood supply to the femoral head and death of bone cells and bone marrow composition, which in turn lead to structural change, collapse of the femoral head, and articular dysfunction. SONFH is a challenging disorder to treat in adults due to frequent collapse of the femoral head and dysfunction of the hip joint. Eventually, patients require joint arthroplasty surgery, which severely impairs the patients' quality of life...
May 30, 2018: Gene
Chao Wang, Junying Sun, Ning Xu, Junjun Zha, Lei Wang
Objective: To explore the mid-term effectiveness of large-head metal-on-metal total hip arthroplasty (THA). Methods: A retrospective analysis was made on the clinical date of 40 patients (43 hips) who were treated with the large-head metal-on-metal THA between April 2009 and June 2010. There were 18 males (20 hips) and 22 females (23 hips) with an average age of 55.1 years (range, 20-85 years). Unilateral hip was involved in 37 cases and bilateral hips in 3 cases...
April 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Ziqi Zhang, Chunsheng Wang, Pei Yang, Xiaoqian Dang, Kunzheng Wang
Objective: To compare the early rehabilitation effects of total hip arthroplasty (THA) with direct anterior approach (DAA) versus posterior approach (PA). Methods: A retrospective analysis was made in the data of 83 patients with unilateral osteonecrosis of the femoral head between March 2014 and May 2017. Forty-eight patients were treated with THA via PA (PA group) and 35 patients were treated with THA via DAA (DAA group). There was no significant difference in gender, age, body mass index, stage of osteonecrosis of the femoral head, and disease duration between 2 groups ( P >0...
March 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Ji Li, Zhongli Li, Xiangzheng Su, Chunhui Liu, Hao Zhang, Ketao Wang
Objective: To evaluate the effectiveness of multiple small-diameter drilling decompression combined with hip arthroscopy for early oeteonecrosis of the femoral head (ONFH). Methods: Between March 2010 and December 2013, 91 patients with early ONFH were treated with the operation of multiple small-diameter drilling decompression combined with hip arthroscopy in 39 cases (53 hips, group A) or with drilling decompression alone in 52 cases (74 hips, group B). The patients in 2 groups had obvious hip pain and limited motion before operation...
September 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Yusuke Osawa, Taisuke Seki, Yasuhiko Takegami, Taiki Kusano, Kazuya Makida, Naoki Ishiguro
PURPOSE: The aim of this study was to compare the clinical outcomes of cementless total hip arthroplasty (THA) used for the treatment of osteonecrosis of the femoral head (ONFH) and for osteoarthritis (OA) at a mean ten years follow-up. METHODS: Case-control study of 78 patients (86 hips) who underwent THA for ONFH treatment (ONFH group). Patients were matched for age and sex to 78 patients (86 hips) who underwent THA for OA (OA group). We compared the clinical and patient-reported outcomes, implant survival rates, and rates of complications between the groups...
May 24, 2018: International Orthopaedics
Tomoyuki Kamenaga, Takafumi Hiranaka, Yuichi Hida, Takaaki Fujishiro, Koji Okamoto
BACKGROUND: There have been very few reports on isolated medial tibial plateau osteonecrosis, and the condition has not been clearly described. Unicompartmental knee arthroplasty (UKA) may be an appropriate treatment method for this condition. The aims of this study were to report our experience of using mobile-bearing knee implants for osteonecrosis of the medial tibial plateau and to discuss the etiology and treatment of this type of osteonecrosis. METHODS: This study included six consecutive patients with isolated medial tibial plateau osteonecrosis treated with an Oxford mobile-bearing knee implant...
May 16, 2018: Knee
Mehdi Miladi, Benoît Villain, Nasser Mebtouche, Thierry Bégué, Jean-Charles Aurégan
PURPOSES: Osteonecrosis of the femoral head (ONFH) is a dramatic condition resulting in joint destruction in the late stages. Total hip arthroplasty allows function recovery with satisfactory implant survival. Recently, the use of uncemented short stems has been suggested to improve the conservation of bone stock. METHODS: We performed a retrospective study on 16 hip arthroplasties-11 patients-implanted for ONFH between 2008 and 2017. We aimed to compare the outcomes of the two types of arthroplasty-"uncemented short" vs "cemented conventional" femoral stem-in terms of pain (visual analogue scale), function (Harris Hip Score), and survival (radiography)...
May 15, 2018: International Orthopaedics
Shunsuke Kawano, Motoki Sonohata, Masaru Kitajima, Masaaki Mawatari
Background: Nerve palsy following total hip arthroplasty (THA) is a complication that worsens the functional prognosis. The present study analyzed the risk factors of nerve palsy following THA. Methods: The subjects of this study included 6,123 cases in which primary THA was performed under spinal anesthesia with cementless implants used in the posterolateral approach. Results: Fourteen cases (0.22%) developed nerve palsy following THA, all of which involved palsy of the entire peroneal nerve region...
2018: Open Orthopaedics Journal
Seneki Kobayashi, Toshikazu Kubo, Yukihide Iwamoto, Wakaba Fukushima, Nobuhiko Sugano
PURPOSE: To identify modifiable factors related to post-operative dislocation and reoperation in patients with osteonecrosis of the femoral head (ONFH) in a large cohort. METHODS: We studied 4995 hip arthroplasties: total hip arthroplasty (THA) was performed in 79% of patients; bipolar hemiarthroplasty (BP), 17%; total resurfacing arthroplasty (tRS), 3%; and hemi-resurfacing arthroplasty (hRS), 1%. A new type of BP (accounting for 49% of BPs) comprised a femoral component with a polished or smooth, small-diameter (approximately 10 mm) neck with a round or oval axial cut surface and no sharp corners...
May 12, 2018: International Orthopaedics
Toby J Colegate-Stone, Saurabh Aggarwal, Karthik Karuppaiah, Adel Tavakkolizadeh, Joydeep Sinha, Ines Lh Reichert
PURPOSE: A formalised, universally accepted, radiological staging system of gleno-humeral joint osteonecrosis (ON) is lacking. Consequently, there is absence of a standardised management strategy. The aim is to propose a simple radiological staging system of gleno-humeral joint ON based on principles of the Association Research Circulation Osseous (ARCO) Society and review of clinical practice. METHODS: A radiographic and clinical review of 45 patients with haematological-induced gleno-humeral ON was performed...
May 11, 2018: International Orthopaedics
Jung Ho Noh, Young Hak Roh
We present a case of osteonecrosis of bipartite patella occurring after total knee arthroplasty using medial parapatellar approach without lateral retinacular release in osteoarthritic knee of a 66 year-old-male. The surgery was performed using traditional technique with medial parapatellar approach and patella was resurfaced. Patella was everted during surgery. There was no event during follow-up period after surgery. Range of motion of the knee was 135° without flexion contracture. Eight months after the surgery, patella was fragmented and resorbed on the radiographs which was consistent with osteonecrosis...
May 5, 2018: Acta Orthopaedica et Traumatologica Turcica
Wayne Hoskins, Johnny Rayner, Rohan Sheehy, Harry Claireaux, Roger Bingham, Roselyn Santos, Andrew Bucknill, Xavier L Griffin
INTRODUCTION: High-energy femoral neck fractures in young patients can be devastating, with the risk of osteonecrosis, nonunion, malunion and lifelong morbidity. The aim of this study is to define the effects of patient, fracture and surgical factors on the outcome of high-energy femoral neck fractures in patients aged from 15 to 50 years. METHODS: A retrospective review was conducted of high-energy femoral neck fractures in patients aged 15-50 managed surgically at a Level 1 Trauma Centre, using a prospectively recorded trauma database...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Jean-Charles Aurégan, Benoît Villain, Thierry Bégué
PURPOSE: Core decompression (CD) may be effective when performed during the early stages of osteonecrosis of the femoral head (ONFH). Tantalum may be added as a rod that would allow putting some mechanical constraints on the femoral head. We aimed to estimate the rate of total hip arthroplasty after CD and insertion of a tantalum rod during early stages of OFNH. METHODS: We searched systematically Medline via PubMed and the Cochrane Library. Our primary endpoint was the rate of patients undergoing a total hip arthroplasty after CD and insertion of a tantalum rod...
May 4, 2018: International Orthopaedics
Yohei Tomaru, Tomokazu Yoshioka, Hisashi Sugaya, Yukiyo Shimizu, Katsuya Aoto, Hiroshi Wada, Hiroshi Akaogi, Masashi Yamazaki, Hajime Mishima
PURPOSE: We had previously established concentrated autologous bone marrow aspirate transplantation (CABMAT), a one-step, low-invasive, joint-preserving surgical technique for treating osteonecrosis of the femoral head (ONFH). This study aimed to evaluate the effects of CABMAT as a hip-preserving surgical approach, preventing conversion to total hip arthroplasty (THA) and femoral head collapse in patients with systemic lupus erythematosus (SLE). METHODS: Since 2003, 52 SLE patients (8 male, 44 female, 92 hips, mean age 35...
April 28, 2018: International Orthopaedics
Woo-Lam Jo, Young-Kyun Lee, Yong-Chan Ha, Tae-Young Kim, Kyung-Hoi Koo
PURPOSE: Osteonecrosis of the femoral head (ONFH) is commonly detected in young patients and most surgeons tend to delay total hip arthroplasty (THA) until the end stage of the disease. We hypothesised that post-operative range of motion (ROM) of the hip as well as baseline ROM at the time of surgery decreases with the disease progression. The purpose of this study was to determine whether patients, who were operated at an advanced stage, have pre- and post-operative hip ROM similar to ROM of patients, who were operated at earlier stages...
April 26, 2018: International Orthopaedics
Kyoko Kasahara, Tomohiro Mimura, Suzuko Moritani, Taku Kawasaki, Shinji Imai, Shunichiro Tsuji, Fuminori Kimura, Takashi Murakami
Subchondral insufficiency fracture (SIF) is a fragility fracture secondary to osteoporosis that leads to collapse of the femoral head with no evidence of osteonecrosis. SIF of the femoral head has been reported in adults of varying ages and both sexes, but it has never been reported to occur in pregnant women. Herein, we describe a 40-year-old primiparous patient with pre-existing anorexia nervosa who developed SIF of the femoral head in the third trimester. At 29 weeks of gestation, the patient complained of sudden pain on walking in both hips...
May 2018: Tohoku Journal of Experimental Medicine
Julio J Jauregui, Christopher L Blum, Neil Sardesai, Craig Bennett, R Frank Henn, Farshad Adib
BACKGROUND: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK's predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK...
May 2018: Journal of Orthopaedic Surgery
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