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osteonecrosis of the femoral head

Shang-Chun Guo, Shi-Cong Tao, Wen-Jing Yin, Xin Qi, Jia-Gen Sheng, Chang-Qing Zhang
Osteonecrosis of the femoral head (ONFH) represents a debilitating complication following glucocorticoid (GC)-based therapy. Synovial-derived mesenchymal stem cells (SMSCs) can exert protective effect in the animal model of GC-induced ONFH by inducing cell proliferation and preventing cell apoptosis. Recent studies indicate the transplanted cells exert therapeutic effects primarily via a paracrine mechanism and exosomes are an important paracrine factor that can be directly used as therapeutic agents for tissue engineering...
2016: International Journal of Biological Sciences
Wataru Ando, Kengo Yamamoto, Tsuyoshi Koyama, Yoshichika Hashimoto, Takashi Tsujimoto, Kenji Ohzono
Idiopathic osteonecrosis of the femoral head (ONFH) can be correctly diagnosed in accordance with the established criteria. However, some general orthopedic physicians have misdiagnosed patients as having ONFH. The goal of this study was to clarify the radiologic and clinical features of misdiagnosed patients. This study included 50 patients who were referred to the authors' hospital by general physicians with a diagnosis of ONFH. The correct diagnosis was made based on the Japanese Investigation Committee diagnostic criteria for ONFH...
October 18, 2016: Orthopedics
Yang Song, Zhenwu Du, Qiwei Yang, Ming Ren, Yujie Sui, Qingyu Wang, Ao Wang, Haiyue Zhao, Jincheng Wang, Guizhen Zhang
The critical roles of IGFBP3 in regulating the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cells strongly indicate its potential effects on the pathogenesis of osteonecrosis of the femoral head (ONFH). In this study, we investigated the association of IGFBP3 gene polymorphism and its protein expression with the development of ONFH to further explore its molecular pathogenesis. Ligase detection reactions and enzyme-linked immunosorbent assay were used to detect the polymorphisms of rs2453839[C/T] and rs3110697[A/G] and the serum protein expression of IGFBP3 gene in 182 cases and 179 controls, respectively...
October 5, 2016: DNA and Cell Biology
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
Jordan C Villa, Solomon Husain, Jelle P van der List, Arianna Gianakos, Joseph M Lane
BACKGROUND: Treatment for osteonecrosis of the femoral head (ONFH) remains controversial. Current reviews include low-level evidence studies evaluating the treatment of both pre-collapse and collapse stages of the disease. QUESTIONS/PURPOSES: The purpose of the current study is to systematically review the literature evaluating core decompression (CD) with bone marrow mesenchymal cells (BMMCs), CD alone, and bisphosphonate treatment in pre-collapse ONFH by focusing just on randomized clinical trials (RCTs) reporting functional and radiologic outcomes...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Sophie Legrève
OBJECTIVE: Multifocal osteonecrosis is rare. A zone of epiphyseal bone-marrow necrosis of three or more joints characterizes it. The most common risk factors are glucocorticoids intake and alcoholism. However, there is a series of other causes that could be incriminated in osteonecrosis, among which antiphospholipid syndrome. This case report, illustrates a primary antiphospholipid syndrome with only one clinical manifestation: multifocal osteonecrosis. OBSERVATIONS: A 30-year-old woman, with a medical history of left total hip replacement (THR), presents with severe right coxalgia and pain in both knees and shoulders...
September 2016: Annals of Physical and Rehabilitation Medicine
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
Vidyadhar V Upasani, Oliver Birke, Kevin E Klingele, Michael B Millis
BACKGROUND: The modified Dunn procedure facilitates femoral capital realignment for slipped capital femoral epiphysis (SCFE) through a surgical hip dislocation approach. Iatrogenic postoperative hip instability after this procedure has not been studied previously; however, we were concerned when we observed several instances of this serious complication, and we wished to study it further. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the frequency, timing, and clinical presentation (including complications) associated with iatrogenic instability after the modified Dunn procedure for SCFE...
September 20, 2016: Clinical Orthopaedics and related Research
Naga Suresh Adapala, Ryosuke Yamaguchi, Matthew Phipps, Olumide Aruwajoye, Harry K W Kim
In children with Legg-Calvé-Perthes disease, loss of blood supply to the femoral head results in ischemic osteonecrosis. Generally, macrophages play important roles in the inflammatory response to tissue necrosis, but their role in ischemic osteonecrosis of the femoral head (ONFH) is not known. The purpose of this study was to determine the macrophage-inflammatory responses after ONFH and the receptor mechanisms involved in sensing the necrotic bone, using a piglet model of Legg-Calvé-Perthes disease. Induction of ONFH resulted in increased numbers of CD14(+) macrophages (4...
September 17, 2016: American Journal of Pathology
Davide Ippolito, Alessandro Masetto, Cammillo Talei Franzesi, Pietro A Bonaffini, Alessandra Casiraghi, Sandro Sironi
AIM: To assess the potential value of femoral head (FH) volume measurements to predict joint collapse, as compared to articular surface involvement, in post-treatment osteonecrosis (ON) in pediatric patients affected by lymphoproliferative diseases. METHODS: Considering 114 young patients with lymphoproliferative diseases undergone a lower-limbs magnetic resonance imaging (MRI) examination between November 2006 and August 2012 for a suspected post-treatment ON, we finally considered a total of 13 cases (7 males, mean age 15...
August 28, 2016: World Journal of Radiology
Jieli Du, Wanlin Liu, Tianbo Jin, Zhenqun Zhao, Rui Bai, Huiqin Xue, Junyu Chen, Mingqi Sun, Xiyang Zhang, Guoqiang Wang, Jianzhong Wang
Osteonecrosis of the femoral head (ONFH) is a common hip joint disease, and steroid-induced ONFH accounts for a large number of cases. Here, we examined eight previously-identified single-nucleotide polymorphisms (SNPs) in the MPP2 and MPP9 genes of 285 steroid-induced ONFH patients and 507 healthy controls from northern China to determine whether these SNPs were associated with the risk of developing steroid-induced ONFH. Chi-squared tests and genetic model and haplotype analyses were used to evaluate associations...
September 15, 2016: Oncotarget
Chun Chen, Zhiguo Qu, Xiaoguang Yin, Chunyu Shang, Qiang Ao, Yongquan Gu, Ying Liu
This is a retrospective analysis of the clinical effects of transplant of mesenchymal stem cells (MSCs) derived from human umbilical cord-derived MSCs (hUC‑MSCs) for the treatment of osteonecrosis of the femoral head (ONFH). The biological characteristics of hUC-MSCs were assessed using flow cytometry. Nine eligible patients were enrolled in the study as they adhered to the Association Research Circulation Osseous (ARCO) classification of stage Ⅱ‑Ⅲa, and hUC‑MSCs were grafted by intra‑arterial infusion...
September 16, 2016: Molecular Medicine Reports
Jieli Du, Tianbo Jin, Yuju Cao, Junyu Chen, Yongchang Guo, Mingqi Sun, Jian Li, Xiyang Zhang, Guoqiang Wang, Jianzhong Wang
BACKGROUND: Steroid-induced osteonecrosis of the femoral head (ONFH) is the most common clinical nontraumatic ONFH. Once ONFH occurs, it seriously reduces patients' quality of life. The matrix metalloproteinase/tissue inhibitor of metalloproteinase (MMP/TIMP) system was found to play a significant role in the development of ONFH. The aim of this study was to identify the associations between 7 genes selected from the MMP/TIMP system and steroid-induced ONFH. METHODS: We genotyped 34 single-nucleotide polymorphisms (SNPs) of 7 genes selected from the MMP/TIMP system in a case-control study with 285 cases of steroid-induced ONFH and 308 healthy controls...
September 2016: Medicine (Baltimore)
Jie Zhao, Xin-Long Ma, Jian-Xiong Ma, Lei Sun, Bin Lu, Ying Wang, Guo-Sheng Xing, Yan Wang, Ben-Chao Dong, Li-Yan Xu, Ming-Jie Kuang, Lin Fu, Hao-Hao Bai, Yue Ma, Wei-Lin Jin
Steroid-associated osteonecrosis (SAON) is one of the common complications of clinical glucocorticoid (GC) administration, with osteocyte apoptosis appearing as the primary histopathological lesion. However, the precise mechanism underlying SAON remains unknown. Epigenetic modification may be a major cause of SAON. Recently, cumulative research revealed that Ten-Eleven Translocation (TET) proteins can catalyze the conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) and then alter the epigenetic state of DNA...
September 13, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
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
G Saviola, L Abdi-Ali, S Sacco, L G Dalle Carbonare
In 2013 a 40 year old man came to visit in our Rheumatology Unit because of a recent bilateral shoulder and hip pain. He had been treated from 1990 to 2000 with Cyclosporin A and Sulfasalazyn because of an ulcerative colitis which was completely in remission from 2000 . Glucocorticoids at the mean daily dose of 50 mg were administered only in the first period (1990-92). X-plain rays showed a suspicious multifocal osteonecrosis of both femoral and humeral heads. Magnetic Resonance confirmed the diagnosis (stage III and IV following Ficat and Arlet's criteria)...
July 2016: La Clinica Terapeutica
Ryan J O'Leary, Melissa D Gaillard, Thomas P Gross
BACKGROUND: The optimal surgical treatment for osteonecrosis of the femoral head has yet to be elucidated. To evaluate the role of femoral fixation techniques in hip resurfacing, we present a comparison of the results for 2 consecutive groups: group 1 (75 hips) received hybrid hip resurfacing implants with a cemented femoral component; group 2 (103 hips) received uncemented femoral components. Both groups received uncemented acetabular components. METHODS: We retrospectively analyzed our clinical database to compare failures, reoperations, complications, clinical results, metal ion test results, and X-ray measurements...
August 9, 2016: Journal of Arthroplasty
Gwy Suk Seo, Gregory Dieudonne, Scott A Mooney, Johnny Uv Monu
BACKGROUND: We observed cases of extensive osteolysis of the femoral head following acetabular fractures even though the original fracture did not involve the femoral head or neck. This observation has been called massive osteolysis of the femoral head (MOFH). PURPOSE: To evaluate the clinical and imaging features of MOFH to gain a better understanding of its patho-etiology. MATERIAL AND METHODS: We retrospectively collected cases of acetabular fractures seen over a period of 10 years and evaluated the clinical features and imaging characteristics...
August 31, 2016: Acta Radiologica
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
Olumide O Aruwajoye, Pranesh B Aswath, Harry K W Kim
Bone morphogenetic protein (BMP)-2 and ibandronate (IB) decrease the femoral head deformity following ischemic osteonecrosis of the femoral head (ONFH). The purpose of this study was to determine the effects of BMP-2 and IB on the mineral content and nanoindentation properties of the bone following ONFH. ONFH was surgically induced in a femoral head of piglets. There were 5 groups: normal control, untreated, IB, BMP, and BMP + IB (n = 5/group). Backscattered electron imaging, Raman spectroscopy, and nanoindentation testing were performed...
August 26, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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