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Osteonecrosis and arthroplasty

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https://www.readbyqxmd.com/read/29776813/unicompartmental-knee-arthroplasty-for-spontaneous-osteonecrosis-of-the-medial-tibial-plateau
#1
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
https://www.readbyqxmd.com/read/29761221/interest-of-short-implants-in-hip-arthroplasty-for-osteonecrosis-of-the-femoral-head-comparative-study-uncemented-short-vs-cemented-conventional-femoral-stems
#2
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
https://www.readbyqxmd.com/read/29755607/risk-factors-for-the-development-of-nerve-palsy-following-primary-total-hip-arthroplasty
#3
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
https://www.readbyqxmd.com/read/29754187/nationwide-multicenter-follow-up-cohort-study-of-hip-arthroplasties-performed-for-osteonecrosis-of-the-femoral-head
#4
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
https://www.readbyqxmd.com/read/29752502/the-staged-management-of-gleno-humeral-joint-osteonecrosis-in-patients-with-haematological-induced-disease-a-cohort-review
#5
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
https://www.readbyqxmd.com/read/29739709/osteonecrosis-of-bipartite-patella-following-total-knee-arthroplasty-without-lateral-release
#6
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
https://www.readbyqxmd.com/read/29734844/the-effect-of-patient-fracture-and-surgery-on-outcomes-of-high-energy-neck-of-femur-fractures-in-patients-aged-15-50
#7
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
https://www.readbyqxmd.com/read/29728733/what-is-the-rate-of-patients-undergoing-a-total-hip-arthroplasty-after-core-decompression-and-insertion-of-a-tantalum-rod-in-osteonecrosis-of-the-femoral-head-a-systematic-review
#8
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
https://www.readbyqxmd.com/read/29705871/mid-term-results-of-concentrated-autologous-bone-marrow-aspirate-transplantation-for-corticosteroid-associated-osteonecrosis-of-the-femoral-head-in-systemic-lupus-erythematosus
#9
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
https://www.readbyqxmd.com/read/29700582/delay-of-total-hip-arthroplasty-to-advanced-stage-worsens-post-operative-hip-motion-in-patients-with-femoral-head-osteonecrosis
#10
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
https://www.readbyqxmd.com/read/29681582/subchondral-insufficiency-fracture-of-the-femoral-head-in-a-pregnant-woman-with-pre-existing-anorexia-nervosa
#11
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...
2018: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29665764/unicompartmental-knee-arthroplasty-for-spontaneous-osteonecrosis-of-the-knee-a-meta-analysis
#12
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
https://www.readbyqxmd.com/read/29663012/medial-joint-line-elevation-of-the-tibia-measured-during-surgery-has-a-significant-correlation-with-the-limb-alignment-changes-following-medial-unicompartmental-knee-arthroplasty
#13
Yuichi Kuroda, Koji Takayama, Kazunari Ishida, Shinya Hayashi, Shingo Hashimoto, Masanori Tsubosaka, Takehiko Matsushita, Takahiro Niikura, Kotaro Nishida, Ryosuke Kuroda, Tomoyuki Matsumoto
PURPOSE: This study aimed to determine the correlation between the change in joint line height calculated from the resected bone and insert thickness during surgery and the change in limb alignment following unicompartmental knee arthroplasty (UKA). It was hypothesized that joint line elevation is correlated with the change in limb alignment. METHODS: A total of 74 consecutive patients diagnosed with either isolated medial compartmental osteoarthritis (38 patients) or spontaneous osteonecrosis of the knee (36 patients) were included...
April 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29662770/predicting-the-collapse-of-the-femoral-head-due-to-osteonecrosis-from-basic-methods-to-application-prospects
#14
REVIEW
Leilei Chen, GuoJu Hong, Bin Fang, Guangquan Zhou, Xiaorui Han, Tianan Guan, Wei He
Collapse of the femoral head is the most significant pathogenic complication arising from osteonecrosis of the femoral head. It is related to the disruption of the maintenance of cartilage and bone, and results in an impaired function of the vascular component. A method for predicting the collapse of the femoral head can be treated as a type of clinical index. Efforts in recent years to predict the collapse of the femoral head due to osteonecrosis include multiple methods of radiographic analysis, stress distribution analysis, finite element analysis, and other innovative methods...
October 2017: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29629588/reliable-outcomes-and-survivorship-of-unicompartmental-knee-arthroplasty-for-isolated-compartment-osteonecrosis
#15
B P Chalmers, K G Mehrotra, R J Sierra, M W Pagnano, M J Taunton, M P Abdel
Aims Primary (or spontaneous) and secondary osteonecrosis of the knee can lead to severe joint degeneration, for which either total or unicompartmental arthroplasty may be considered. However, there are limited studies analyzing outcomes of unicompartmental knee arthroplasties (UKAs) for osteonecrosis involving an isolated compartment of the knee. The aims of this study were to analyze outcomes of UKAs for osteonecrosis with specific focus on 1) survivorship free of any revision or reoperation, 2) risk factors for failure, 3) clinical outcomes, and 4) complications...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29627891/anabolic-agents-what-is-beyond-osteoporosis
#16
REVIEW
Y Liu, A E Levack, E Marty, O Or, B P Samuels, M Redko, J M Lane
Osteoporosis is a common skeletal disorder characterized by low bone mass, which leads to reduced bone strength and an increased risk of fractures. Anabolic agents have been shown to improve bone mass and decrease fracture risk in osteoporosis patients by directly stimulating osteoblasts to produce new bone. Currently, two anabolic agents are available in the USA: recombinantly produced teriparatide (TPTD), which is the fully active (1-34) amino active sequence of human parathyroid hormone (PTH), and abaloparatide (APTD), a synthetic analog of parathyroid hormone-related peptide (PTHrP)...
April 7, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29619500/early-stage-osteonecrosis-of-the-femoral-head-where-are-we-and-where-are-we-going-in-year-2018
#17
REVIEW
Eric Larson, Lynne C Jones, Stuart B Goodman, Kyung-Hoi Koo, Quanjun Cui
Osteonecrosis of the femoral head (ONFH) is a devastating condition affecting relatively young patients whereby the femoral head is necrotic, resulting in significant pain, articular surface collapse, and eventual osteoarthritis. This condition has been highly associated with chronic steroid use, alcoholism, and hip trauma, as well as other less common conditions. Without intervention, this condition has a high likelihood of progressing and developing into end-stage osteoarthritis. Unfortunately, ONFH is difficult to diagnose on plain radiographs in the early stages of the disease, and often requires more advanced imaging modalities such as MRI in order to fully assess for early degeneration...
April 4, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29611159/perioperative-outcomes-and-short-term-complications-following-total-knee-arthroplasty-in-chronically-immunosuppressed-patients
#18
Gannon L Curtis, Morad Chughtai, Anton Khlopas, Jared M Newman, Assem A Sultan, Nipun Sodhi, Wael K Barsoum, Carlos A Higuera, Michael A Mont
BACKGROUND: Although there are studies regarding immunosuppressed patients undergoing total knee arthroplasty (TKA) for inflammatory arthritis or osteonecrosis, there is a paucity of studies evaluating immunosuppressed patients undergoing TKA for diagnoses other than these. MATERIALS AND METHODS: We identified all patients undergoing primary TKA for osteoarthritis from 2008-2014 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29602969/raman-spectroscopy-reveals-differences-in-molecular-structure-between-human-femoral-heads-affected-by-steroid-associated-and-alcohol-associated-osteonecrosis
#19
Ema Nakahara, Zhu Wenliang, Giuseppe Pezzotti, Hidetoshi Hamada, Masaki Takao, Takashi Sakai, Nobuhiko Sugano
PURPOSE: The purposes of this study were to document novel Raman spectroscopic findings in femoral heads affected by osteonecrosis and to identify molecular structure differences based on aetiology. METHODS: We obtained 13 femoral heads with osteonecrosis from 13 different patients who underwent total hip arthroplasty. Comparisons were made between the viable zones of each femoral head examined. The samples were scanned with X-ray micro-CT for structural mapping and a central coronal section slab was prepared for Raman spectroscopy and histological analyses...
March 30, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29589086/subchondral-stem-cell-therapy-versus-contralateral-total-knee-arthroplasty-for-osteoarthritis-following-secondary-osteonecrosis-of-the-knee
#20
Philippe Hernigou, Jean Charles Auregan, Arnaud Dubory, Charles Henri Flouzat-Lachaniette, Nathalie Chevallier, Helene Rouard
PURPOSE: Total knee arthroplasty (TKA) implanted in patients with secondary osteonecrosis (ON) related to corticosteroids have relatively poor outcome (20% revision rate) at a mean follow-up of only eight years. With the hypothesis that subchondral bone marrow injection might improve knees in these patients, we evaluated 30 patients who had bilateral knee osteoarthritis with severe joint space narrowing and received TKA in one knee and subchondral bone marrow concentrate injection in the contralateral knee...
March 27, 2018: International Orthopaedics
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