Clinical image: Additive risk factors resulting in severe osteonecrosis in systemic lupus erythematosus

Duran-Barragán, Sergio; Sandoval-Garcia, Leon; Navarrete-Lorenzon, Martha

doi:10.1002/art.27679

Cited by 5 publications

(1 citation statement)

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“…Steroid-associated osteonecrosis (SAON) is one of the serious complications that occurs after pulsed administration of steroids in several medical conditions, including rheumatic diseases, such as systemic lupus erythematosus, as well as organ transplantation and severe acute respiratory syndrome (1)(2)(3)(4). Recent advances in the understanding of the pathophysiology of SAON have shown that bone repair at the early stages of this disorder is inadequate, due to the decreased activity of the bone marrow-derived stem cell (BMSC) pool (5)(6)(7)(8)(9).…”

Section: Conclusion Cryopreserved Bmmncs Maintained Their Bioactivitmentioning

confidence: 99%

Promotion of bone repair by implantation of cryopreserved bone marrow–derived mononuclear cells in a rabbit model of steroid‐associated osteonecrosis

Xie

Wang

et al. 2012

Arthritis & Rheumatism

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Objective. Cytotherapy is an insufficient method for promoting bone repair in steroid-associated osteonecrosis (SAON), and this has been attributed to impairment of the bioactivity of bone marrow-derived stem cells (BMSCs) after pulsed administration of steroids. Cryopreserved autologous bone marrowderived mononuclear cells (BMMNCs), which contain BMSCs, might maintain their bioactivity in vitro. This study sought to investigate the effects of cryopreserved BMMNCs, before steroid administration, on the enhancement of bone repair in an established rabbit model of SAON.Methods. For in vitro study, bone marrow was harvested 4 weeks before SAON induction from the iliac crests of rabbits (n ‫؍‬ 10) to isolate fresh BMMNCs, and the BMMNCs were then cryopreserved for 8 weeks. Both the fresh and the cryopreserved BMMNCs were evaluated for their bioactivity and osteogenic differentiation capacity. In addition, BMMNCs were isolated 2 weeks after SAON induction and subjected to the same evaluations. For in vivo study, cryopreserved BMMNCs were implanted into the bone tunnel during core decompression of the femur (n ‫؍‬ 12 rabbits) after the induction of SAON, and tissue regeneration was evaluated by micro-computed tomography and histologic analyses at 12 weeks postoperation.Results. In vitro, there were no significant differences in the bioactivity or ability to undergo osteogenic differentiation between fresh BMMNCs and cryopreserved BMMNCs, but after SAON induction, both features were decreased significantly. In vivo, the bone mineral density, ratio of bone volume to total volume of bone, and volume and diameter of neovascularization within the bone tunnel were significantly higher in the BMMNC-treated group compared to the nontreated control group at 12 weeks postoperation.Conclusion. Cryopreserved BMMNCs maintained their bioactivity and promoted bone regeneration and neovascularization within the bone tunnel after core decompression in this rabbit model of SAON.

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Section: Conclusion Cryopreserved Bmmncs Maintained Their Bioactivitmentioning

confidence: 99%

Promotion of bone repair by implantation of cryopreserved bone marrow–derived mononuclear cells in a rabbit model of steroid‐associated osteonecrosis

Xie

Wang

et al. 2012

Arthritis & Rheumatism

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Osteonecrosis in systemic lupus erythematosus: Systematic insight from the epidemiology, pathogenesis, diagnosis and management

Zheng

Zhang

et al. 2022

Autoimmunity Reviews

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Evaluation of core decompression outcome in systemic lupus erythematosus with hip osteonecrosis: a retrospective cohort study

Hadighi,

Faezi,

Mortazavi

et al. 2024

Adv Rheumatol

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Background Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. Methods In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. Results In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphosphonate use (P < 0.02). Of the 23 studied cases, the mean cumulative dose of prednisolone before and after core decompression surgery was 46.41 mg and 14.74 mg respectively. Besides, one case (2.6%) that had a high anti-phospholipid antibodies level during follow-up did not have any radiographic deterioration, and 9 cases (23.1%) had some degrees of radiographic deterioration. Conclusions The patients group that used bis-phosphonate, had a higher level of satisfaction with joint function after core decompression. Patients with high-level anti-phospholipid antibodies are related to a poor prognosis after core decompression.

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Clinical image: Additive risk factors resulting in severe osteonecrosis in systemic lupus erythematosus

Cited by 5 publications

References 0 publications

Promotion of bone repair by implantation of cryopreserved bone marrow–derived mononuclear cells in a rabbit model of steroid‐associated osteonecrosis

Promotion of bone repair by implantation of cryopreserved bone marrow–derived mononuclear cells in a rabbit model of steroid‐associated osteonecrosis

Osteonecrosis in systemic lupus erythematosus: Systematic insight from the epidemiology, pathogenesis, diagnosis and management

Evaluation of core decompression outcome in systemic lupus erythematosus with hip osteonecrosis: a retrospective cohort study

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