<p>Transient Osteoporosis of the Hip: Risk and Therapy</p>

Abstract

The aim of this study was to investigate the impact of occupation in patients with transient osteoporosis of the hip (TOH). The study also compares two different types of management for this condition: conservative treatment and surgical drilling. Methods: This was a retrospective case series study. The medical records for patients diagnosed with TOH at our institution within the period 2012-2017 were retrieved. General demographic data, clinical features, and diagnostic modalities were obtained. In addition, management procedures and their associated prognostic factors were acquired. The effectiveness of these procedures was assessed by the number of days of sick leave, the time needed for full recovery and the number of recurrences of TOH. Also, pain responses at 24 hrs, 48 hrs, and at 1 week were estimated subjectively through a "pain score" out of 10, and objectively through the degree of improvement in daily activity. The patients had a regular follow-up at 4-to 6-week intervals. Results: In total, 15 cases of TOH, 14 men and one woman, were enrolled in the study. The mean age of the patients was 41 years (range 26-59 years). Out of the 15 cases, nine were healthcare professionals (eight physicians and one nurse). Ten patients underwent hip drilling for core decompression and five patients were treated conservatively. The time needed for full recovery was 5.8 weeks for those who underwent drilling, and 48.3 weeks for three patients receiving conservative treatment. The other two patients who were treated conservatively had not achieved full or near-full recovery at the time of reporting this study. Conclusion: Physicians may be at increased risk of developing TOH. Further studies should be conducted to examine the role of this occupation as a risk factor. In addition, hip drilling should be considered as an effective treatment modality, especially in those patients who seek a faster recovery.

Transient osteoporosis of the hip: Physicians the occupation of at risk

“… 4 In another study, of 15 patients with TOH, eight (53.3%) were physicians. 2 So, it has been revealed that physicians, particularly, are associated with an increased risk of having TOH.…”

“…According to the proposed venous occlusion pathophysiology, the greater incidence of doctors may be accounted for by their lengthy durations of standing and protracted work sessions. 2 …”

“… 1 Some studies mention that hip drilling patients usually recover in less than a month, faster than conservative therapy. 2 , 7 …”

“… 1 In addition, physicians may be at an elevated risk of getting TOH due to their job. 2 Herein, we present a TOH case physician.…”

Reviewing Bone Marrow Edema in Athletes: A Difficult Diagnostic and Clinical Approach

“…Among them, core decompression and calcium phosphate bone substitute are included [25]. According to the literature, core decompression results in faster functional recovery, less chance of recurrence and better control of pain symptoms than patients treated with NSAIDs or paracetamol [35]. Calcium phosphate injection is a valuable technique by which fluid synthetic calcium phosphate is injected to fill the space between the trabeculae of spongy bone in the subchondral region, which is also referred to as subchondroplasty.…”