Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 2: Alcohol-Associated Osteonecrosis

Yoon, Byung‐Ho; Jones, Lynne C.; Ch, Chen; Cheng, Edward Y.; Cui, Quanjun; Drescher, Wolf; Fukushima, Wakaba; Gangji, Valérie; Goodman, Stuart B.; Ha, Yong‐Chan; Hernigou, Philippe; Hungerford, Marc W.; Iorio, Richard; Jo, Woo-Lam; Khanduja, Vikas; Kim, Harry K.W.; Kim, Shin‐Yoon; Kim, Tae-Young; Lee, Hee Young; Lee, Mel S.; Lee, Yong Seuk; Lee, Yun Jong; Mont, Michael A.; Sakai, Takashi; Sugano, Nobuhiko; Takao, Masaki; Yamamoto, Takuya; Koo, Kyung‐Hoi

doi:10.1016/j.arth.2018.09.006

Cited by 56 publications

(45 citation statements)

References 44 publications

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“…Alcohol consumption is considered as a vital risk factor for non‐traumatic ONFH . A myriad of epidemiologic studies indicated that a substantial number of ONFH patients were due to alcohol overuse .…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact pathogenesis of non‐traumatic ONFH has not been fully elucidated, several risk factors have been identified, including corticosteroids medication, alcohol consumption and several autoimmune diseases . Actually, alcoholism is one of the leading risk factors for ONFH worldwide, and epidemiologic studies indicated that 20%‐45% of ONFH patients were due to alcohol overuse …”

Section: Introductionmentioning

confidence: 99%

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Osthole stimulates bone formation, drives vascularization and retards adipogenesis to alleviate alcohol‐induced osteonecrosis of the femoral head

Zhu

Liu

et al. 2020

J Cellular Molecular Medi

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Characteristic pathological changes in osteonecrosis of the femoral head (ONFH) include reduced osteogenic differentiation of bone mesenchymal stem cells (BMSCs), impaired osseous circulation and increased intramedullary adipocytes deposition. Osthole is a bioactive derivative from coumarin with a wide range of pharmacotherapeutic effects. The aim of this study was to unveil the potential protective role of osthole in alcohol‐induced ONFH. In vitro, ethanol (50 mmol/L) remarkably decreased the proliferation and osteogenic differentiation of BMSCs and impaired the proliferation and tube formation capacity of human umbilical vein endothelial cell (HUVECs), whereas it substantially promoted the adipogenic differentiation of BMSCs. However, osthole could reverse the effects of ethanol on osteogenesis via modulating Wnt/β‐catenin pathway, stimulate vasculogenesis and counteract adipogenesis. In vivo, the protective role of osthole was confirmed in the well‐constructed rat model of ethanol‐induced ONFH, demonstrated by a cascade of radiographical and pathological investigations including micro‐CT scanning, haematoxylin‐eosin staining, TdT‐mediated dUTP nick end labelling, immunohistochemical staining and fluorochrome labelling. Taken together, for the first time, osthole was demonstrated to rescue the ethanol‐induced ONFH via promoting bone formation, driving vascularization and retarding adipogenesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Osthole stimulates bone formation, drives vascularization and retards adipogenesis to alleviate alcohol‐induced osteonecrosis of the femoral head

Zhu

Liu

et al. 2020

J Cellular Molecular Medi

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“…Of the 123 patients who were diagnosed with ONFH and underwent CT, 27 had pre-collapse ONFH with an ARCO stage of 1 or 2, 6 which satisfied the previously described ROI condition ( Table 1) Factors associated with ONFH included corticosteroid usage in 15 patients and alcohol abuse in 12 patients. 18,19 Several characteristics differed significantly between ONFH and control participants, particularly sex (p < .01). Therefore, propensity score matching was conducted to unify the baseline characteristics.…”

Section: Differences In Hu Values Between Patients With Pre-collapsmentioning

confidence: 99%

Is bone mineral density lower in the necrotic lesion in pre‐collapse osteonecrosis of the femoral head?

Baba

Motomura

Ikemura

et al. 2020

Journal Orthopaedic Research

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The purpose of this study was to clarify whether bone mineral density (BMD) of the necrotic lesion in precollapse osteonecrosis of the femoral head (ONFH) is reduced according to Hounsfield unit (HU) values on computed tomography (CT). The superior one-third of the femoral head in the coronal section was set as the region of interest (ROI) for the measurement of HU values. First, HU values of 101 control participants were assessed to identify relevant confounding factors. Next, the relationship between HU values and BMD on dual-energy X-ray absorptiometry (DXA) was verified. Then the mean HU value of the ROI in patients with pre-collapse ONFH was compared with that in propensity score-matched control participants. Finally, the HU values of the lateral boundary in the patients with and without subsequent collapse were compared. Multivariable analysis showed that both age and BMI were significantly correlated with the HU value, which showed a strong correlation with the BMD of the femoral neck on DXA (r = 0.92). In 25 ONFH patients and 25 propensity-matched control participants, no significant difference was found in the HU value of the ROI (p = .54). The mean HU value of the lateral boundary in patients with subsequent collapse was found to be significantly higher than that in patients without subsequent collapse (p < .01). The assessment of HU values on CT was useful for the evaluation of BMD of the femoral head. The current assessment did not demonstrate reduced bone mineral density of the necrotic lesion in pre-collapse ONFH K E Y W O R D S bone mineral density, dual-energy X-ray absorptiometry, Hounsfield unit, osteonecrosis of the femoral head, propensity score matching 1 | INTRODUCTION In the course of osteonecrosis of the femoral head (ONFH), the occurrence of collapse, including subchondral fracture, is the most important event influencing the fate of the affected hip joint. While patients usually have no symptoms unless collapse occurs, collapse results in severe hip pain, and worsened joint congruity, resulting in secondary osteoarthritis. 1 Although efforts have been made to prevent the occurrence of collapse, 2,3 there is no established prophylactic treatment since the precise mechanisms of collapse remain unknown.

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“…However, the outcomes were individually different; therefore, the factors that led to this difference were investigated. First, etiology was revealed as a predictor [18,19], but in the present study, it was unlikely significant and violated the proportional hazards assumption. Gender (P = 0.2599), age (P = 0.0730), BMI (P = 0.0015), HHS (P < 0.0001), and ARCO stage (P = 0.4853) were than analyzed as independent risk factors for progression.…”

Section: Discussionmentioning

confidence: 54%

Prognosis after autologous peripheral blood stem cell transplantation for osteonecrosis of the femoral head in the pre-collapse stage: a retrospective cohort study

Pan

Ding

et al. 2020

Stem Cell Res Ther

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Objectives: Autologous peripheral blood stem cell (auto-PBSC) transplantation is an effective therapeutic for the osteonecrosis of the femoral head (ONFH) but without prognosis estimation. This study mainly aimed to (1) determine whether auto-PBSC transplantation is a promising option, (2) assess the risk of hip-preservation failure, (3) achieve a predictive model of femoral head survival after the intervention, and (4) eventually identify clinical indications for auto-PBSC transplantation in future. Methods: After reviewing the in-patient database of the First Affiliated eligible patients with Association Research Circulation Osseous stage I or II ONFH who were receiving intra-arterial infusion of auto-PBSCs were recruited. A case form was designed to retrieve relevant data. Hip-preservation failure was defined as the endpoint. All participants were stratified by the categorical risk of collapse, which was statistically tested through log-rank analysis. All significant factors were evaluated using Cox proportional hazards regression model, and a predictive nomogram plot was generated. Results: In total, 47 hips were followed up for 53.96 ± 21.09 months; the median survival time was 60.18 months. Among the predictors, body mass index (BMI; P = 0.0015) and Harris hip score (HHS; P < 0.0001) independently affected femoral head survival. Patients with BMI ≥ 24 kg/m 2 exhibited a 2.58 times higher risk of hip-preservation failure [95% confidence interval (CI), 1.32-5.45] than those with BMI < 24 kg/m 2 , whereas those with HHS ≥ 70 exhibited a 0.19 times lower risk (95% CI, 0.09-0.38) than those with HHS < 70. Hazard ratios associated with age (P = 0.042), BMI (P = 0.012), HHS (P = 0.022), and necrotic volume (P = 0.000) were 1.038 (95% CI, 1.001-1.075), 1.379 (95% CI, 1.072-1.773), 0.961 (95% CI, 0.928-0.994), and 1.258 (95% CI, 1.120-1.412), respectively. A nomogram plot (score test P = 0.000; C-index = 0.8863) was available for the orthopedic doctor to predict hip survival probability. Conclusions: The results suggest that intra-arterial infusion of auto-PBSCs prolongs femoral head survival. Age, BMI, HHS, and necrotic volume can influence the efficacy of this intervention. This study was approved by ethics committee of the trial center, number 2019-KL-075-01.

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Etiologic Classification Criteria of ARCO on Femoral Head Osteonecrosis Part 2: Alcohol-Associated Osteonecrosis

Cited by 56 publications

References 44 publications

Osthole stimulates bone formation, drives vascularization and retards adipogenesis to alleviate alcohol‐induced osteonecrosis of the femoral head

Osthole stimulates bone formation, drives vascularization and retards adipogenesis to alleviate alcohol‐induced osteonecrosis of the femoral head

Is bone mineral density lower in the necrotic lesion in pre‐collapse osteonecrosis of the femoral head?

Prognosis after autologous peripheral blood stem cell transplantation for osteonecrosis of the femoral head in the pre-collapse stage: a retrospective cohort study

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