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Kamran Balighi, Maryam Daneshpazhooh, Nessa Aghazadeh, Vahide Saeidi, Farzam Shahpouri, Pardis Hejazi, Cheyda Chams-Davatchi
HINTERGRUND UND ZIELE: Pemphigus vulgaris (PV) wird in der Regel mit systemischen Corticosteroiden und Immunsuppressiva behandelt. Avaskuläre Nekrose (AVN) des Hüftkopfes ist eine gut bekannte schwerere Komplikation einer Corticosteroid-Therapie. Die Charakteristika dieser schweren Komplikation bei PV sind nach wie vor unbekannt. PATIENTEN UND METHODEN: Nicht kontrollierte, retrospektive Untersuchung aller PV-bedingten AVN-Fälle, die in einer iranischen Klinik für bullöse Autoimmunerkrankungen zwischen 1985 und 2013 diagnostiziert wurden...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Kamran Balighi, Maryam Daneshpazhooh, Nessa Aghazadeh, Vahide Saeidi, Farzam Shahpouri, Pardis Hejazi, Cheyda Chams-Davatchi
BACKGROUND AND OBJECTIVES: Pemphigus vulgaris (PV) is typically treated with systemic corticosteroids and immunosuppressive agents. Avascular necrosis (AVN) of the femoral head is a well-recognized major complication of corticosteroid therapy. The characteristics of this serious complication in PV remain unknown. PATIENTS AND METHODS: Uncontrolled, retrospective study of all PV-related AVN cases diagnosed at an Iranian autoimmune bullous disease clinic between 1985 and 2013...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
S P Mohanty, K A Singh, R Kundangar, V Shankar
BACKGROUND: The purpose of this study was to compare the clinical and radiological outcomes of multiple small diameter drilling and core decompression with fibular strut grafting in the management of non-traumatic avascular necrosis (AVN) of the femoral head. MATERIALS AND METHODS: Outcomes of patients with AVN treated by multiple small diameter drilling (group 1) were compared retrospectively with patients treated by core decompression and fibular grafting (group 2)...
October 18, 2016: Musculoskeletal Surgery
R H Emerson, O Alnachoukati, J Barrington, K Ennin
AIMS: Approved by the Food and Drug Administration in 2004, the Phase III Oxford Medial Partial Knee is used to treat anteromedial osteoarthritis (AMOA) in patients with an intact anterior cruciate ligament. This unicompartmental knee arthroplasty (UKA) is relatively new in the United States, and therefore long-term American results are lacking. PATIENTS AND METHODS: This is a single surgeon, retrospective study based on prospectively collected data, analysing a consecutive series of primary UKAs using the Phase III mobile-bearing Oxford Knee and Phase III instrumentation...
October 2016: Bone & Joint Journal
Parikshit S Sharma, Faiz A Subzposh, Kenneth A Ellenbogen, Pugazhendhi Vijayaraman
BACKGROUND: Conduction disease is not uncommon after prosthetic valve (PV) surgery. The feasibility of His bundle pacing (HBP) in this patient (pt) population is not well studied. OBJECTIVE: We report our experience with permanent HBP in pts undergoing pacemaker (PM) implantation following PV surgery. METHODS: Permanent HBP was attempted in pts with AV conduction disease post PV surgery referred for PM implantation. Conduction disease was characterized as AV nodal vs infra-nodal...
September 20, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
L A Archer, A Furey
PURPOSE: Avascular necrosis (AVN) of the humeral head is a devastating complication of proximal humeral fracture (PHF) that often results in long-term morbidity for the patient. Rates of AVN depend on the number of fracture fragments and are highly variable. The literature suggests that timely stable and anatomic reduction may decrease the rate at which AVN develops after PHF. To our knowledge, there is no literature published investigating a temporal relationship between the timing of PHF fixation and rates of AVN...
September 20, 2016: Musculoskeletal Surgery
A Asmus, M Lautenbach, B Schacher, S Kim, A Eisenschenk
BACKGROUND: Operative treatment of the scaphoid nonunion includes avascular corticocancellous and cancellous bone grafts and increasingly the use of vascular pedicled and free vascular corticocancellous grafts. Especially the latter require a fair amount of operative expertise and experience in microsurgical techniques. OBJECTIVE: Which criteria lead to the decision for or against an avascular graft used for reconstruction of scaphoid nonunion? Is our current classification system of a scaphoid pseudarthrosis able to illustrate our diagnostic potential in a way that makes us refer to operative procedures? METHODS: Evaluation of current literature and expert opinions RESULTS: Avascular bone grafts show a high union rate as long as a sufficient vascularisation of the remaining fragments is present...
September 16, 2016: Der Orthopäde
Yusuke Kohno, Yasuharu Nakashima, Toshio Kitano, Taichi Irie, Atsushi Kita, Tomoyuki Nakamura, Hirosuke Endo, Yosuke Fujii, Takayuki Kuroda, Shigeru Mitani, Hiroshi Kitoh, Masaki Matsushita, Tadashi Hattori, Koji Iwata, Yukihide Iwamoto
BACKGROUND: An unstable slipped capital femoral epiphysis (SCFE) is associated with a high rate of avascular necrosis (AVN). The etiology of AVN seems to be multifactorial, although it is not thoroughly known. The aims of our study were to determine the rate of AVN after an unstable SCFE and to investigate the risk factors for AVN, specifically evaluating the notion of an "unsafe window", during which medical interventions would increase the risk for AVN. METHODS: This retrospective multicenter study included 60 patients with an unstable SCFE diagnosed between 1985 and 2014...
September 11, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
P D Analan
Radiotherapy (RT) is an important component of treatment for malignant tumours and avascular necrosis (AVN), which is often associated with high morbidity and disability, frequently accompanies this type of therapy. It generally develops in the same extremity with the treated region and may continue long after the treatment is completed. Early identification of AVN has the potential to reduce morbidity and improve the patient's quality of life. Herein, we present a case of contralateral humerus avascular necrosis diagnosed immediately after the first round of RT in a patient with breast cancer...
February 22, 2016: West Indian Medical Journal
Brice Ilharreborde, Vincent Cunin, Saad Abu-Amara
BACKGROUND: There is growing evidence that symptomatic femoroacetabular impingement (FAI) can develop after severe slipped capital femoral epiphysis (SCFE) fixed in situ. Realignment procedures have therefore gained popularity, but complication rates remain controversial. Among them, the subcapital shortening osteotomy without hip dislocation has been progressively adopted in France, but results have never been assessed to date. METHODS: All cases performed in 23 French university hospitals between January 2010 and March 2014 were reviewed to (1) describe the surgical procedure, (2) assess the radiologic and functional outcomes, and (3) report complications and more specifically the avascular necrosis rate (AVN) according to initial stability...
September 3, 2016: Journal of Pediatric Orthopedics
Tiffany Yu, Timothy Campbell, Isabella Ciuffetelli, Carlton Haywood, Christopher Patrick Carroll, Linda Resar, John J Strouse, Sophie Lanzkron
OBJECTIVES: Sickle cell disease (SCD) is associated with high healthcare utilization rates and poor outcomes in a subset of patients, although the underlying factors that predict this phenotype are poorly understood. Prior studies suggest that comorbid avascular necrosis (AVN) contributes to high healthcare utilization. We sought to clarify whether AVN independently predicts acute care utilization in adults with SCD and to identify characteristics of those with AVN that predict higher utilization...
September 2016: Southern Medical Journal
M Olsen, P M Lewis, Z Morrison, M D McKee, J P Waddell, E H Schemitsch
AIMS: One method of femoral head preservation following avascular necrosis (AVN) is core decompression and insertion of a tantalum rod. However, there may be a high failure rate associated with this procedure. The purpose of this study was to document the clinical and radiological outcomes following total hip arthroplasty (THA) subsequent to failed tantalum rod insertion. PATIENTS AND METHODS: A total of 37 failed tantalum rods requiring total hip arthroplasty were identified from a prospective database...
September 2016: Bone & Joint Journal
Raju Vaishya, Amit Kumar Agarwal, Nishint Gupta, Vipul Vijay
Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks...
August 2016: Journal of Hip Preservation Surgery
Mayank Gupta, R-K Arya, Satish Kumar, Vijay-Kumar Jain, Skand Sinha, Ananta-Kumar Naik
PURPOSE: Both cannulated cancellous screw (CCS) and sliding hip screw (SHS) are used in femoral neck fracture fixations, but which is superior is yet to be determined. This study was aimed to compare the clinicoradiological outcome of femoral neck fracture treated with SHS or CCS in young adults. METHODS: Adults (16e60 years) with femoral neck fracture were divided into Group 1 fixed with SHS and Group 2 fixed with three CCS after closed reduction. Pain relief, functional recovery and postoperative radiographs at 6 weeks, 3 months, 6 months and then yearly for upto 4 years were analyzed...
August 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Brian P Chalmers, Cameron K Ledford, Joseph M Statz, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
INTRODUCTION: As patients who receive hematopoietic stem cell transplantation are at increased risk of avascular necrosis (AVN) and subsequent degenerative arthritis, THA may be considered in some of these patients, particularly as overall patient survival improves for patients undergoing stem-cell transplants. Patients receiving hematopoietic stem cell transplantation theoretically are at increased risk of experiencing complications, infection, and poorer implant survivorship owing to the high prevalence of comorbid conditions, immunosuppressive therapy regimens including corticosteroids, and often low circulating hematopoietic cell lines; however, there is a paucity of studies elucidating these risks...
August 19, 2016: Clinical Orthopaedics and related Research
Baris Beytullah Koc, Martijn Schotanus, Bob Jong, Pieter Tilman
Avascular necrosis (AVN) of the scaphoid in children is very rare and there is currently no consensus when conservative or operative treatment is indicated. A 10-year-old boy, practicing karate, presented with acute pain in his left wrist after falling on the outstretched hand. Imaging showed a scaphoid waist fracture with signs of an ongoing AVN. The diagnosis of AVN was confirmed with signal loss of the scaphoid on MRI T1. A dynamic contrast-enhanced MRI was performed for further assessment of the proximal pole vascularity and treatment planning...
2016: Case Reports in Orthopedics
Alicia Cowan, Joao Panattoni
Kienböck disease, or lunate avascular necrosis, can lead to chronic wrist pain and instability. Its etiology appears to be multifactorial including variations in adjacent anatomical structures, interrupted blood supply, and trauma. Capitate-hamate fusion is the second most commonly diagnosed carpal coalition and not treated unless symptomatic. Coalitions may alter the wrist mechanics depending on their extent. No prior reports have associated Kienböck disease with capitate-hamate coalition. We present 2 cases with congenital capitate-hamate fusion and lunate AVN...
October 2016: Journal of Hand Surgery
D D Baksi, A K Pal, D P Baksi
BACKGROUND: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN) of femoral head...
July 2016: Indian Journal of Orthopaedics
Ming-Yue Xiong, Li-Qiang Liu, Shi-Qiong Liu, Zhen-Hui Liu, Hang-Fei Gao
Avascular necrosis of femoral head (AVFH) is a clinically recalcitrant disease of hip that leads to joint destruction. Osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B (RANK) and RANK ligand (RANKL) regulates the balance, maturation and function of osteoclast and bone remodeling. This study aims to investigate molecular pathways which leads to AVN by studying expression profile of OPG, RANK and RANKL genes. Quantitative Real Time-PCR is used to evaluate mRNA expression of OPG, RANK and RANKL...
2016: American Journal of Translational Research
Tinen L Iles, Brian Howard, Stephen Howard, Stephen Quallich, Christopher Rolfes, Eric Richardson, Hanna R Iaizzo, Paul A Iaizzo
To date, many pharmacological agents used to treat or prevent arrhythmias in open-heart cases create undesired systemic side effects. For example, antiarrhythmic drugs administered intravenously can produce drops in systemic pressure in the already compromised cardiac patient. While performing open-heart procedures, surgeons will often either create a small port or form a pericardial cradle to create suitable fields for operation. This access yields opportunities for target pharmacological delivery (antiarrhythmic or ischemic preconditioning agents) directly to the myocardial tissue without undesired side effects...
2016: Journal of Visualized Experiments: JoVE
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