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osteonecrosis of the femoral head

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
Kenneth W DeFontes, Joshua Vaughn, Jeremy Smith, Eric M Bluman
Talar body osteonecrosis can be a devastating, painful condition that is difficult to manage surgically when conservative treatments have failed. With early disease, nonoperative treatments can prolong the need for operative correction in the young patient. Later stage disease with extensive involvement may require a tibiotalocalcaneal (TTC) arthrodesis to retain functionality of the limb. This situation frequently requires a structural bone graft. Using the technique described in this article, the void resulting from collapse of the talar body is filled with talar allograft, which offers a more anatomic and structurally rigid construct than previously described methods using an allograft femoral head...
March 1, 2018: Foot & Ankle International
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
Pei-Hsun Sung, Hsin-Ju Chiang, Yao-Hsu Yang, John Y Chiang, Chi-Jen Chen, Hon-Kan Yip, Mel S Lee
PURPOSE: Endothelial dysfunction is a risk factor for osteonecrosis of femoral head (ONFH) and venous thromboembolism (VTE) [defined as deep venous thrombosis (DVT) or pulmonary embolism (PE)]. However, the risk of unprovoked VTE in non-traumatic ONFH patients remains unclear. METHODS: We investigated the relationship between ONFH and VTE using Taiwan National Health Insurance Research Database (NHIRD). Between 1997 and 2010, a total of 1514 non-traumatic ONFH patients were identified from 1,000,000 general populations after excluding initially concomitant diagnoses of DVT and PE, and subjects undergoing lower limb surgery within one year since enrollment...
March 14, 2018: International Orthopaedics
Keun Jung Ryu
No abstract text is available yet for this article.
April 2018: Clinical Orthopaedics and related Research
Xiang Hu, Bao-Jian Liu, Xiao-Ming Wen, Yong-Hao Zheng, Ke Jia
OBJECTIVE: To investigate the clinical effect of internal fixation with closed reduction and hollow compression screws for the treatment of femoral neck fracture in young and middle-aged patients. METHODS: From June 2013 to December 2016, 33 young and middle-aged patients with femoral neck fractures were treated with hollow compression screws fixation including 17 males and 16 females with an average age of 38.5 years old ranged from 19 to 59 years old; 20 cases were on the left side and 13 cases on the right side;the time from injury to operation ranged from 2 to 5 days with an average of 3 days...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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
Yusuke Osawa, Taisuke Seki, Yasuhiko Takegami, Takehiro Kasai, Yoshitoshi Higuchi, Naoki Ishiguro
PURPOSES: The objectives of this study were to investigate patient-reported outcomes and referral pain at the first visit in patients with osteonecrosis of the femoral head (ONFH) and to clarify the influence of collapse of the femoral head and the contralateral condition. METHODS: The study included 105 patients (130 hips) with ONFH at the first visit, who were divided into two groups based on the presence of bilateral walking hip pain (bilateral group 25 patients, 50 hips) and unilateral hip pain (unilateral group 80 patients, 80 hips)...
March 9, 2018: International Orthopaedics
Yizhong Peng, Yuenan Liu, Donghua Huang, Wei Huang, Zengwu Shao
PURPOSE: The association between TNF-α-308(G/A) and -238(G/A) polymorphisms and the susceptibility of non-traumatic osteonecrosis of the femoral head (NONFH) was investigated in many studies with conflicting results. We aimed to conduct a meta-analysis to evaluate the relationship between them comprehensively. METHODS: Relevant literatures published in PubMed, Web of Science, Embase, Cochrane library databases, China National Knowledge Infrastructure (CNKI), WANFANG Data, and China Science and Technology Journal Database (CSTJ) updated to January 30, 2018, were reviewed by two investigators independently...
March 7, 2018: International Orthopaedics
Ding Zhou, Yi-Xuan Chen, Jun-Hui Yin, Shi-Cong Tao, Shang-Chun Guo, Zhan-Ying Wei, Yong Feng, Chang-Qing Zhang
Glucocorticoids (GCs) are the most common cause of atraumatic osteonecrosis of the femoral head (ONFH) because their effect compromises the osteogenic capability of bone marrow‑derived mesenchymal stem cells (BMSCs). Valproic acid (VPA) is a widely used anti‑epileptic and anti‑convulsant drug. Previous studies have reported that VPA promotes osteogenic differentiation of MSCs in vitro and osteogenesis in vivo as a histone deacetylase (HDAC) inhibitor. The purpose of the present study was to investigate the efficacy of VPA as a precautionary treatment of ONFH after GC treatment in rats...
March 6, 2018: International Journal of Molecular Medicine
Baijun Hu, Dawei Gao, Yihe He
OBJECTIVES: The aim of this study is to investigate the efficacy of fibula fixation in the early treatment of osteonecrosis of the femoral head (ONFH). METHODS: 130 patients with ONFH were selected and randomly divided into control group and observation group. Patients in the control group received core decompression treatment, while patients in the observation group received fibula fixation. The local microcirculation was observed by dynamic contrast-enhanced MRI, necrotic volume was measured using MRI, articular surface collapse by using X-ray, McGill pain questionnaire was used to understand and compared the joint pain condition...
March 1, 2018: Journal of Musculoskeletal & Neuronal Interactions
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
Pei-Hsun Sung, Yao-Hsu Yang, Hsin-Ju Chiang, John Y Chiang, Chi-Jen Chen, Hon-Kan Yip, Mel S Lee
BACKGROUND: Endothelial dysfunction has been identified as an etiologic factor for osteonecrosis of the femoral head (ONFH) and major adverse cardiovascular and cerebrovascular events (defined as major cardiovascular disease [CVD] and cerebrovascular accident [CVA]). However, the incidence of major adverse cardiovascular and cerebrovascular events in patients with nontraumatic ONFH and any association between the two diagnoses remain unclear. QUESTIONS/PURPOSES: We compared a large cohort of patients with nontraumatic ONFH and a matched control group without this diagnosis and (1) examined the frequency and hazard ratio (HR) of major adverse cardiovascular and cerebrovascular events in both groups adjusted for age, sex, socioeconomic status, and associated comorbidities (which we defined as the adjusted HR), (2) determined whether any association of ONFH and major adverse cardiovascular and cerebrovascular events was stable after adjusting for confounding variables, and (3) compared the occurrence of major adverse cardiovascular and cerebrovascular events with time in both groups...
February 14, 2018: Clinical Orthopaedics and related Research
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
C Mourad, K Laperre, M Halut, C Galant, M Van Cauter, B C Vande Berg
OBJECTIVES: To describe a stepwise process to obtain fused images from micro-computed tomography (μCT) and histological images of bone specimens. MATERIAL AND METHODS: Four surgically resected human femoral heads from four patients who had total hip replacement were imaged at a spatial resolution of 12-microns by using μCT. Histological sections of four focal bone lesions including bone cyst in osteoarthritis (n=2) and subchondral bone plate fracture in osteonecrosis (n=2) were prepared and digitized...
February 20, 2018: Diagnostic and Interventional Imaging
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
J-C Escudier, M Ollivier, M Donnez, S Parratte, P Lafforgue, J-N Argenson
INTRODUCTION: Recent reports described possible mechanical factors in the development and aggravation of osteonecrosis of the femoral head (OFH), but these have yet to be confirmed on dedicated mechanical study. We therefore developed a 3D finite element model based on in-vivo data from patients with incipient OFH, with a view to determining whether the necrosis area was superimposed on the maximal stress area on the femoral head. HYPOTHESIS: The location of the necrosis area is determined by stress on the femoral head...
February 17, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Zhi-Wei Chen, Tai-Xian Li, Xiao-Xu Wan, Rong-Tian Wang, Wei-Heng Chen
OBJECTIVE: To evaluate the status and risk factors for the misdiagnosis of femoral head osteonecrosis, providing the basis for accurate diagnosis of osteonecrosis of femoral head. METHODS: The data of 314 hospitalized patients were collected from March 2015 to March 2016, and the risk factors for osteonecrosis of femoral head were analyzed by Logistic regression model. Misdiagnosis was defined that the diagnosis given on the first time was different from that on the second time or that given by expert group with the same symptoms and signs...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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
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