Experimental Model Study of Ischemic Necrosis Induction of the Growing Femoral Head

Abstract

Many experimental models exist to better understand the necrosis of the femoral head etiology, both in terms of the species variety in which necrosis is induced and in the operative techniques used for treatment. Objective: This study has two main objectives, the first is to review the literature concerning experimental models of avascular necrosis of the growing femoral head, the second, to demonstrate the experimental pig model’s reproducibility using a pilot study. Methods: This was a bibliographic review to describe the attempts over time to find the best species and technique for induction that would reproduce ischemic necrosis of the growing femoral head in humans. Simultaneously, a pilot study was performed to verify the replication of induction in pigs, the species that has more similarities with the human hip. The pilot’s methodological analysis consists of conventional radiology and verification of possible anatomical, pathological changes. Results: In imaging exams; lateral sub-dislocation of the femur head and triangular appearance of the head were observed, characterizing its flattening; in macroscopic examination, the femoral head flattening with femoral neck widening and shortening was identified; in histology, the proliferation of articular cartilage with the presence of vascular granulation regenerative tissue, with osteoclasts and fibrocartilaginous tissue in the metaphyseal femoral neck region was identified. Conclusion: The experimental pig model can be used as a valuable tool for the reproducibility of anatomical, pathological changes in ischemic necrosis of the growing femoral head. The model is reproducible and feasible and can be beneficial for future studies on the anatomical pathology of necrosis of the growing femoral head. Level of Evidence III, Literature Review .

Osteochondritis Dissecans of the Hip in Legg-Calvé-Perthes Disease: Case Report and Review

“…LCPD is characterized by unilateral or bilateral necrosis of the femoral head, which results from a proximal femoral epiphysis ischaemia of unknown etiology and affects the range of motion of the hip. [1][2][3][4]6,7,9 Age at disease onset and diagnosis, sex, range of motion of the hip and severity of the disease / necrosis are considered potential prognostic factors in LCPD. Despite early treatment efforts, many patients evolve with residual femoral head deformity that may be symptomatic with a residual limp and decreased hip motion [1][2][3]10,12,13 OCD is rare as an isolated cause of late pain following LCPD.…”

“…Legg-Calvé-Perthes disease (LCPD) refers to idiopathic osteonecrosis of the capital femoral epiphysis in children. 1 – 4 It is a self-healing condition in which the blood supply to the capital femoral epiphysis spontaneously recovers by means of recanalization of pre-existing vessels that occurs precociously within weeks after the necrosis, or eventually formation of new vessels over a period of months to years. 1 , 4 – 7 The clinical onset of LCPD usually occurs in children between ages of four and eight years, with the condition being five times more common in males than females.…”

“… 1 – 4 It is a self-healing condition in which the blood supply to the capital femoral epiphysis spontaneously recovers by means of recanalization of pre-existing vessels that occurs precociously within weeks after the necrosis, or eventually formation of new vessels over a period of months to years. 1 , 4 – 7 The clinical onset of LCPD usually occurs in children between ages of four and eight years, with the condition being five times more common in males than females. 1 , 2 , 5 During the healing process, abnormal proximal femoral growth results in varying deformities, which predisposes to hip joint incongruity, femoroacetabular impingement, chondrolysis and labral tears.…”