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Osteonecrosis and arthroplasty

Jemin Yi, Kye Young Han, Young Jun Nam, Keun Woo Kim
PURPOSE: This study aimed to investigate the outcomes of modular neck-utilization in primary total hip arthroplasty (THA). MATERIALS AND METHODS: Thirty patients (34 hips) who had modular stem THA between April 2011 and January 2013 were evaluated. There were 19 men and 11 women with a mean age of 61.2 years at the time of surgery. There were 20 cases of osteonecrosis of femoral head, 7 cases of osteoarthritis, 6 cases of femur neck fracture, and 1 case of rheumatoid arthritis...
September 2016: Hip Pelvis
Simona Gurzu, Sabin Gligore Turdean, Sorin Tudor Pop, Ancuta Zazgyva, Ciprian Oliviu Roman, Mihaela Opris, Ioan Jung
PURPOSE: To present a hypothesis regarding the pathways of angiogenesis in primary versus secondary hip osteoarthritis (OA). METHODS: In synovial tissue samples provided by 57 consecutive patients who underwent hip arthroplasty, immunohistochemical examinations were performed using the following angiogenesis-related antibodies: VEGF-A, COX-2, maspin and the endothelial cells markers CD31 and CD105. The cases were divided into three categories: classic primary hip OA (group A; n = 16), rapidly destructive hip OA (group B; n = 24) and hip OA secondary to avascular osteonecrosis of the femoral head (group C; n = 17)...
October 4, 2016: International Orthopaedics
Ching-Jen Wang, Chung-Cheng Huang, Hon-Kan Yip, Ya-Ju Yang
BACKGROUND: This study investigated the effects of different dosages of extracorporeal shockwave therapy (ESWT) in early osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS: Thirty-three patients (42 hips) were randomly divided into three groups. Group A (10 patients with 16 hips) received 2000 impulses of ESWT at 24 Kv to the affected hip. Group B (11 patients with 14 hips) and Group C (12 patients with 12 hips) received 4000 and 6000 impulses of ESWT respectively...
September 21, 2016: International Journal of Surgery
Sonya Khurana, Roy I Davidovitch, Young K Kwon, Joseph D Zuckerman, Kenneth A Egol
BACKGROUND: In order to compare open reduction and internal fixation (ORIF) with locked plating to hemiarthroplasty for the treatment of three- and four-part proximal humerus fractures, we compared two groups of patients treated during the same time period. MATERIALS AND METHODS: Sixty-five patients who underwent repair of a three- or four-part proximal humerus fracture with locked plates (Group A) were identified in a prospective database and were compared to 29 patients who underwent hemiarthroplasty for similar injuries (Group B)...
September 2016: Bulletin of the Hospital for Joint Diseases
Zan A Naseer, Malick Bachabi, Lynne C Jones, Robert S Sterling, Harpal S Khanuja
Osteonecrosis is one of the most devastating musculoskeletal manifestations of sickle cell disease and most commonly affects the femoral head. Although the exact pathophysiology of this condition in patients with sickle cell disease is unknown, it is suggested that red cell sickling and repetitive vaso-occlusion may be associated with tissue hypoxia, inflammation, and subsequent bone necrosis and collapse. If left untreated, osteonecrosis can be extremely debilitating and may lead to severe pain, loss of function, and degenerative joint changes...
September 2016: Southern Medical Journal
Ashok S Gavaskar, Bhupesh Karthik B, Naveen C Tummala, Parthasarathy Srinivasan, Hitesh Gopalan
OBJECTIVES: Humeral head sacrificing procedures are more favored in elderly patients with complex proximal humerus fractures because of high incidence of failures and complications with osteosynthesis. The purpose of this study is to assess the outcome of second generation locked plating techniques in 3 and 4 part fractures in active elderly patients >70years with an emphasis on function and complications. MATERIALS AND METHODS: 29 patients with displaced 3 and 4 part proximal humerus fractures were treated using the principles of second-generation proximal humerus locked plating...
August 24, 2016: Injury
M Berruto, P Ferrua, F Uboldi, S Pasqualotto, F Ferrara, G Carimati, E Usellini, M Delcogliano
BACKGROUND: This study aimed to assess the reliability of the Maioregen® biomimetic osteochondral scaffold (Finceramica Faenza SpA, Faenza, Italy) as a salvage and joint-preserving procedure in the treatment of late-stage osteonecrosis of the knee. METHODS: Eleven active patients aged under 65years and presenting with clinical and radiological signs of SPONK were treated with Maioregen®. All were clinically evaluated pre-operatively and yearly thereafter for a minimum of two years...
August 31, 2016: Knee
Toshiaki Okura, Yukiharu Hasegawa, Daigo Morita, Yusuke Osawa, Naoki Ishiguro
INTRODUCTION: The purpose of this study was to examine the 10-year survivorship and clinical outcome after curved intertrochanteric varus osteotomy (CVO) for the osteonecrosis of the femoral head (ONFH), and to determine what factors predict the failure of this procedure. MATERIALS AND METHODS: We retrospectively reviewed 102 consecutive CVOs in 93 patients diagnosed with ONFH. Mean follow-up duration was 10.1 years (3.0-23.2 years). Factors associated with radiographic failure (secondary collapse and/or osteoarthritic change), conversion to total hip arthroplasty (THA) and low Harris Hip Score (HHS), were assessed...
August 29, 2016: Archives of Orthopaedic and Trauma Surgery
Young Wook Lim, Seung Chan Kim, Soon Yong Kwon, Do Joon Park, Yong Sik Kim
PURPOSE: Patients with aplastic anemia (AA) are now living longer and therefore are at increased risk for the development of osteonecrosis of the hip. However, studies on the results of total hip arthroplasty (THA) are lacking. The purpose of this study is to present the result of THA in patients with AA. MATERIALS AND METHODS: We retrospectively reviewed the data for a group of 29 patients (45 hips) with AA who presented to our institution for THA between May 2008 and May 2012...
March 2016: Hip Pelvis
Jin-Young Lee, Jae-Woo Kwon, Jung-Seob Park, Kyeol Han, Woo-Jin Shin, Jeong-Gil Lee, Byung Hoon Lee
PURPOSE: To evaluate clinical results of extracorporeal shock wave therapy (ESWT) with radiographic staging on patients with avascular necrosis of femoral head (AVNFH). MATERIALS AND METHODS: We evaluated 24 patients diagnosed with AVNFH (32 hip joints) who were treated with ESWT from 1993 to 2012. Average follow-up period was 27 months, and the average age of patients was 47.8 years. The Association Research Circulation Osseous (ARCO) system was used to grade radiographic stage prior to treatment...
December 2015: Hip Pelvis
Joo-Hyoun Song, Suk Ku Han, Kyung-Hoon Lee, Jae-Min Lee, Kee-Haeng Lee
PURPOSE: The purpose of this study is to compare the perioperative blood loss in primary non-cemented total hip arthroplasty (THA) performed for rapidly destructive coxarthrosis (RDC) with the perioperative blood loss in primary non-cemented THA for typical osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS: From January 2000 to December 2013, 19 patients were diagnosed with RDC (group 1) and 40 patients were diagnosed typical Ficat stage IV ONFH (group 2), comparison of perioperative blood loss between group 1 and group 2 in primary noncemented THA was done...
September 2015: Hip Pelvis
Soong Joon Lee, Jeong Joon Yoo, Hee Joong Kim
BACKGROUND: Total hip arthroplasty (THA) for sequelae of Legg-Calve-Perthes disease (LCPD) involves specific concerns for deformity, leg length discrepancy (LLD), and relatively young age. Excellent long-term outcome has been proven after Alumina-Alumina (Al-Al) THA for relatively young patients, however, there was no study for Al-Al THA for LCPD sequelae. The aim of this study is to evaluate the results of Al-Al THA for LCPD sequelae and to compare the results with those for adult-onset ONFH, in which THA is necessitated in relatively young age and excellent long term outcome has been proven after Al-Al THA...
August 10, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Brian T Samuelsen, Eric R Wagner, Matthew T Houdek, Bassem T Elhassan, Joaquin Sánchez-Sotelo, Robert Cofield, John W Sperling
BACKGROUND: Reverse total shoulder arthroplasty (RTSA) has classically been reserved for patients older than 65 years with rotator cuff arthropathy, pseudoparalysis, and severe pain. This investigation assessed outcomes in a consecutive series of patients aged 65 and younger undergoing primary RTSA. METHODS: There were 63 patients (67 shoulders; 40 women, 27 men) with a mean age of 60 years (range, 50-65 years). Indications were cuff tear arthropathy (CTA) in 51, severe glenohumeral arthritis in 15, and osteonecrosis in 1...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Ahmed M Samy
BACKGROUND: Osteonecrosis of the femoral head (ONFH) is a debilitating disease in orthopedics, frequently progressing to femoral head collapse and osteoarthritis. It is thought to be a multifactorial disease. ONFH ultimately results in femoral head collapse in 75-85% of untreated patients. Total hip arthroplasty (THA) yields satisfactory results in the treatment of the end stage of the disease. However, disease typically affects males between the ages of 20 and 40 years and joint replacement is not the ideal option for younger patients...
July 2016: Indian Journal of Orthopaedics
Maxime Fabre-Aubrespy, Matthieu Ollivier, Sébastien Pesenti, Sébastien Parratte, Jean-Noël Argenson
BACKGROUND: Due to the potential reduction of morbidity and mortality, unicompartmental knee arthroplasty (UKA) may represent an interesting solution for older patients with unicompartmental arthritis. It was our hypothesis that UKA can represent an alternative to total knee arthroplasty (TKA) for patients older than 75. We, thus, aimed to compare in those patients (1) functional results, (2) rates of forgotten joint, and (3) survivorships of UKA vs TKA. METHODS: In this retrospective matched-pair study, 101 patients who underwent UKA in our institution were included and then matched one-to-one with TKA group based on age, gender, body mass index, preoperative Knee Society Score (KSS)...
June 29, 2016: Journal of Arthroplasty
Fuqiang Gao, Wei Sun, Wanshou Guo, Bailiang Wang, Liming Cheng, Zirong Li
Osteonecrosis of the femoral head (ONFH) following femoral neck fractures is a rare, yet severe, disorder in children and adolescents. This study evaluated the effectiveness of core decompression (CD) combined with implantation of bone marrow-derived cells (BMDC) and rhBMP-2 for osteonecrosis of femoral head (ONFH) after femoral neck fractures in children and adolescents. This study included 51 patients, aged 11.4-18.1 years, with ARCO stages I-III ONFH after femoral neck fractures between 2004 and 2010. The hips were divided into two groups based on whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups...
2016: Scientific Reports
Manuel Scimeca, Maurizio Feola, Lorenzo Romano, Cecilia Rao, Elena Gasbarra, Elena Bonanno, Maria Luisa Brandi, Umberto Tarantino
Bone metabolism is affected by mechanical, genetic, and environmental factors and plays a major role in osteoporosis. Nevertheless, the influence of environmental pollution on the occurrence of osteoporosis is still unclear and controversial. In this context, heavy metals are the most important pollutants capable to affect bone mass. The aim of this study was to investigate whether heavy metals accumulation in bone tissues could be related to the altered bone metabolism and architecture of osteoporotic patients...
July 27, 2016: Environmental Toxicology
Cheng Wang, Yu Wang, Haoye Meng, Wenlong Gou, Xueling Yuan, Xiaolong Xu, Aiyuan Wang, Quanyi Guo, Jiang Peng, Shibi Lu
This study aimed to compare the microstructure and nanomechanical properties of single trabecular bone in different regions of osteonecrosis of the femoral head. Osteonecrotic femoral heads were taken from 20 patients undergoing total hip arthroplasties between 2011 and 2014. Following incision, resin was embedded and polished, and divided into four regions according to the type of pathologic change; i.e., subchondral bone, and necrotic, sclerotic, and healthy regions. Indents from a single trabecular bone of each region were randomly selected to undergo nanoindentation...
March 2016: Journal of Nanoscience and Nanotechnology
Wei Zuo, Wei Sun, Fuqiang Gao, Zirong Li, Bailiang Wang, Zhencai Shi
OBJECTIVE: To analyze the effectiveness of bone grafting through windowing at the femoral head-neck junction for the treatment of osteonecrosis with the segmental collapse of the femoral head. METHODS: The clinical data were retrospectively analyzed from 106 patients (131 hips) with osteonecrosis with the segmental collapse of the femoral head who underwent bone grafting through windowing at the femoral head-neck junction between March 2011 and December 2013. There were 78 males and 28 females, with an average age of 31...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
Maria Chiara Meloni, W Russalka Hoedemaeker, Victor Fornasier
PURPOSE: vascularized fibular grafting has been used to treat osteonecrosis of the femoral head in younger patients. Although the results described in the literature are promising, the failure rate is still significant, especially in steroid users. This study was undertaken to learn more, on a histopathological level, about the mechanism of vascularized fibular graft failure. METHODS: fifteen femoral heads removed at conversion to total hip arthroplasty were analyzed...
January 2016: Joints
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