Analysis of the long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head

Zhao, Pengfei; Hao, Jing

doi:10.1051/medsci/201834f108

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…[154] It was reported that CaSO 4 /CaPO 4 can effectively alleviate the clinical symptoms and delay femoral head collapse in repairing ONFH. [90,155] Recently, a novel therapy combining core decompression with injectable CaSO 4 /CaPO 4 achieved success in clinic in repairing ONFH. [156][157][158] It is suggested that the therapy can promote femoral neck stability and accelerate bony rehabilitation.…”

Section: 12mentioning

confidence: 99%

Bone tissue engineering for treating osteonecrosis of the femoral head

Bian

et al. 2023

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Osteonecrosis of the femoral head (ONFH) is a devastating and complicated disease with an unclear etiology. Femoral head-preserving surgeries have been devoted to delaying and hindering the collapse of the femoral head since their introduction in the last century. However, the isolated femoral head-preserving surgeries cannot prevent the natural progression of ONFH, and the combination of autogenous or allogeneic bone grafting often leads to many undesired complications. To tackle this dilemma, bone tissue engineering has been widely developed to compensate for the deficiencies of these surgeries. During the last decades, great progress has been made in ingenious bone tissue engineering for ONFH treatment. Herein, we comprehensively summarize the state-of-the-art progress made in bone tissue engineering for ONFH treatment. The definition, classification, etiology, diagnosis, and current treatments of ONFH are first described. Then, the recent progress in the development of various bone-repairing biomaterials, including bioceramics, natural polymers, synthetic polymers, and metals, for treating ONFH is presented. Thereafter, regenerative therapies for ONFH treatment are also discussed. Finally, we give some personal insights on the current challenges of these therapeutic strategies in the clinic and the future development of bone tissue engineering for ONFH treatment. K E Y WO R D S biomaterials, bone tissue engineering, osteonecrosis of the femoral head, regenerative therapy  Yixin Bian and Tingting Hu contributed equally to this work.

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Section: 12mentioning

confidence: 99%

Bone tissue engineering for treating osteonecrosis of the femoral head

Bian

et al. 2023

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“…More recently, significant focus has been on the concurrent use of growth and differentiation-inducing agents following core decompression to promote native bone regeneration of the decompressed tract. In particular, methods including autologous bone grafting [15], tantalum rod implants [52][53][54], autologous bone marrow cell implants [55], and synthetic calcium sulfate/calcium phosphate bone cementing [56][57][58][59][60][61][62] have been described for core decompression in the femoral head. Although current literature on biologics for core decompression of the humeral head is limited, several techniques have been proposed.…”

Section: Adjunctive Biologic Treatmentmentioning

confidence: 99%

Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

et al. 2023

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Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

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“…In osteogenesis, calcium sulfate hemihydrate powder forms a solid precipitate through an agglutination reaction after hydration. Hence, a stable environment for the growth of new bone or solid mechanical support for regional grafting can be established by the bone conduction of calcium sulfate hemihydrate powder, bearing a portion of stress conduction (20). Also, bone substitute is an option to avoid donor site complications.…”

Section: Biological Enforcement Of Core Decompression Autologous Bone...mentioning

confidence: 99%

Osteonecrosis of the Femoral Head. Optimizing the Early-Stage Joint-Preserving Surgical Treatment?

VAVOURAKIS¹

2022

Maedica

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Osteonecrosis of the femoral head (ONFH) is a debilitating condition with various etiologies. Comprehension of the pathophysiology of the disease is limited, adding to the challenge of devising a clinically effective treatment strategy. High clinical suspicion and magnetic resonance imaging aid early diagnosis, leading to less invasive and more effective treatment. Recent advancements in joint-preserving surgical treatment have led to improved outcomes, reduced pain, and a higher hip survival rate for early onset osteonecrosis of the femoral head compared with more invasive approaches such as total hip replacement. Core decompression is the gold standard procedure to relieve the ischemic area of the femoral head and is crucial in the early stage of osteonecrosis. The addition of biologic regenerative agents to core decompression is auspicious as they can introduce new cells to the area of necrosis, osteoinductive and osteoconductive agents, while enhancing healing and cellular repair. Adjunctive bone marrow-derived cell therapies have been advocated, potentially aiding the regenerative process. Arthroscopic core decompression and robot-assisted orthopaedic surgery are believed to improve the precision of graft placement, decreasing radiation and operative time. The current study provides a comprehensive review and update of the literature surrounding the latest developments regarding joint-preserving surgical treatment for patients with osteonecrosis of the femoral head. Keywords: osteonecrosis, core decompression, hip preservation, femoral head, avascular necrosis, bone-graft.

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Analysis of the long-term efficacy of core decompression with synthetic calcium-sulfate bone grafting on non-traumatic osteonecrosis of the femoral head

Cited by 8 publications

References 12 publications

Bone tissue engineering for treating osteonecrosis of the femoral head

Bone tissue engineering for treating osteonecrosis of the femoral head

Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

Osteonecrosis of the Femoral Head. Optimizing the Early-Stage Joint-Preserving Surgical Treatment?

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