Bone Marrow Edema Syndrome in Postpartal Women: Treatment with Iloprost

Aigner, N; Meizer, R; Meraner, Dominik; Becker, Stephan; Meizer, E; Landsiedl, F

doi:10.1016/j.ocl.2008.10.007

Cited by 23 publications

(16 citation statements)

References 32 publications

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“…It has been shown to be efficacious in the treatment of BML at various locations, 64 avascular osteonecrosis, except for terminal cases, 63 and regional transient osteoporosis. 65,66 One study compared the effects of iloprost and the bisphosphonate ibandronate on BMLs in the knee and found similar results with around 47% reduction in BMLs and improvement of pain and functions scores.…”

Section: Pharmaceutical Optionsmentioning

confidence: 96%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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Bone marrow lesions (BMLs) or using older terminology 'Bone marrow edema' is characterised by excessive water signals in the marrow space on magnetic resonance imaging or ultrasound; BMLs constitute a central component of a wide variety of inflammatory and non-inflammatory rheumatologic conditions affecting the musculoskeletal system: BMLs are not only considered significant sources of pain but also linked to increased disease activity in many musculoskeletal conditions (for example, osteoarthritis, rheumatoid arthritis). The purpose of this review is to summarise current knowledge about the treatment of BMLs, with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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Section: Pharmaceutical Optionsmentioning

confidence: 96%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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“…Initial studies evaluating Iloprost for the treatment of AVN demonstrated good results, particularly in patients that presents with early stages of AVN. 20-26 Aigner et al 21 evaluate 6 patients with talus bone marrow edema treated with one cycle of Iloprost similar to the dosage used in our study and reported excellent outcome (Mazur foot score: 58 to 93 points) with no progression in the stage of the lesion at final follow-up. In a follow up study, Meizer et al .…”

Section: Discussionmentioning

confidence: 54%

“… 15-19 In the recent years Iloprost has also been used in the therapy of early stage avascular osteonecrosis and bone marrow edema with promising short-term results. 20-26 In this study, we evaluated 108 patients with a total of 136 avascular osteonecrosis in different joint locations and ARCO stages that have been managed with medical Iloprost therapy during the period of 2003 to 2010. The aim of the present study was to investigate the mid to long-term results of Iloprost therapy in treatment of bone marrow edema or avascular osteonecrosis.…”

Section: Introductionmentioning

confidence: 99%

Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis

2016

Orthop Rev

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The treatments of avascular osteonecrosis (AVN) include both conservative and surgical methods which are dependent on the stage and progression of the disease. The vasoactive-prostaglandin-analogue iloprost (PGI2) has been utilized in several areas of medicine and recently has been used for the treatment of AVN. A total of 108 patients with 136 osteonecrosis of different joints, etiology and severity were treated with iloprost. The mean follow-up was 49.71 months: range 15-96 months, and outcome measurements recorded regarding subjective complaints, visual analog scale (pain), function and survival. The outcome scores used include the Harris Hip Score, Knee Society score, Foot and Ankle Survey, visual analogue scale (VAS) and a separate questionnaire. The location and etiology of AVN in our study demonstrated the typical pattern. All of the observed side effects of the therapy were minor and completely reversible. Most of patients (74.8%) showed a significant improvement of subjective complaints and decrease in VAS pain scores after the treatment with iloprost. However, 20% of the treated joints with the stadium Association for Research on Osseous Circulation (ARCO) grade 2, 71% with ARCO 3 and 100% with ARCO 4 underwent subsequent total joint replacement. The medical treatment of bone marrow edema or avascular osteonecrosis by Iloprost provides an safe and effective alternative strategy in the management of AVN presenting in the early stages (ARCO 1 or 2). For more advanced stages (ARCO 3 or 4), surgical intervention should be prioritized.

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“…In another study by Aigner et al, 35 iloprost infusion was studied in women postpartum. Eight hips were assessed using VAS.…”

Section: Bisphosphonatesmentioning

confidence: 99%

Bone marrow edema syndrome of the hip

Ting

Arora

2016

Current Orthopaedic Practice

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Bone marrow edema syndrome of the hip is a rare condition that presents with self-limiting functional disability disproportionate to pain and signal changes on MRI consistent with bone marrow edema. Its etiology has not been established, but the most convincing theory implicates venous outflow obstruction from the diseased segment of bone. Bone marrow edema syndrome is a diagnosis of exclusion, following comprehensive work-up to rule out similarly presenting lesions. Once a diagnosis has been made a number of treatment strategies have been proposed, all with limited evidence. Conservative management is only supportive and involves analgesia and restricted weight bearing. Medical management with bisphosphonates and iloprost yield satisfactory results with minimal adverse effects. Alternative therapies include extracorporeal shock wave and hyperbaric oxygen therapy. Surgical core decompression offers immediate pain relief and faster recovery but may only be offered for severe, refractory disease.

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Bone Marrow Edema Syndrome in Postpartal Women: Treatment with Iloprost

Cited by 23 publications

References 32 publications

Treatment of bone marrow lesions (bone marrow edema)

Treatment of bone marrow lesions (bone marrow edema)

Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis

Bone marrow edema syndrome of the hip

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