Osteonecrosis of the Femoral Head

Jagt, Dick van der; Mokete, Lipalo; Pietrzak, J; Zalavras, Charalampos G.; Lieberman, Jay R.

doi:10.5435/jaaos-d-14-00431

Cited by 38 publications

(30 citation statements)

References 9 publications

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“…Although the data suggest that HGF therapy only yields poor results (HHS < 70), but our data are still comparable to previous relevant studies [30][31][32][33]. Alendronate is one of the most commonly used pharmacological treatments for ONFH [34]. In 2005, an RCT study included 20 patients who received 25-week alendronate treatment, reported a mean HHS of 74.4 AE 7.8 after a follow-up duration 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 of 2 years [32].…”

Section: Discussionsupporting

confidence: 86%

Chinese herbal Huo-Gu formula for the treatment of steroid-associated osteonecrosis of femoral head: A 14-year follow-up of convalescent SARS patients

Huang

et al. 2020

Journal of Orthopaedic Translation

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A R T I C L E I N F O Keywords: Chinese herbal medicine Huo-Gu formula Osteonecrosis of the femoral head SARS Steroid-related osteonecrosis S U M M A R Y Purpose: The coronavirus disease 2019 (COVID-19) reminds us of the severe acute respiratory syndrome (SARS) outbreak in 2003, and up to date, corticosteroid is commonly administrated to severe patients with COVID-19.Osteonecrosis of the femoral head (ONFH) is a common disabling complication among convalescent SARS patients who received corticosteroid therapy. In China, a considerable number of convalescent SARS patients with steroid-associated ONFH had undergone conservative treatment by traditional Chinese medicine, and this study aims to evaluate the long-term results of a spleen-invigorating Huo-Gu formula (HGF) therapy in these patients. Participants and methods: A total of 33 convalescent SARS patients (9 males and 24 females) with bilateral steroidassociated ONFH (66 hips) were enrolled in this study. All patients received oral HGF therapy for 6 months when they were confirmed the diagnosis of steroid-associated ONFH. They had been regularly followed up at an interval of 1 year. Harris hip score and medical imaging modalities, including plain radiography, computed tomography and magnetic resonance imaging, were performed to evaluate the outcomes. Results: Based on average 14 years of follow-up of HGF therapy (ranging from 6 to 16 years), 38 hips (57%) among the 66 hips developed definite osteoarthritis, and 14 hips (26%) in 53 precollapse hips (Association Research Circulation Osseous [ARCO] Stage I or II) progressed to femoral head collapse (ARCO Stage III or IV). Only five patients (also 5 hips) underwent total hip arthroplasty, and the mean hip survival time was over 15 years by the Kaplan-Meier analysis. We observed a mean Harris hip score of 63 points, which represented the reserve of 55% in pain score and 70% in physical function score. The severity of groin pain was not correlated to the severity of osteoarthritis. Conclusion: Chinese herbal HGF therapy demonstrates beneficial effects on preventing femoral head collapse, delaying total hip arthroplasty, and maintaining physical function in the treatment of steroid-associated ONFH. HGF therapy might be therefore a good alternative for the treatment of steroid-associated ONFH secondary to rheumatologic and infection diseases.

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Section: Discussionsupporting

confidence: 86%

Chinese herbal Huo-Gu formula for the treatment of steroid-associated osteonecrosis of femoral head: A 14-year follow-up of convalescent SARS patients

Huang

et al. 2020

Journal of Orthopaedic Translation

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“…Various joint preservation procedures have been performed for the treatment of precollapse disease [5]. However, in the absence of appropriate therapeutic interventions in the early stage, the collapse of the femoral head may later become unavoidable, resulting in severe secondary osteoarthritis and warranting artificial joint replacement in nearly 70% of patients [6,7]. Thus, there is an urgent requirement to identify effective diagnostic biomarkers for SONFH.…”

Section: Introductionmentioning

confidence: 99%

Expression Profile Analysis of Differentially Expressed Circular RNAs in Steroid-Induced Osteonecrosis of the Femoral Head

Zhu

et al. 2019

Disease Markers

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Background. A growing number of studies have suggested that circular RNAs (circRNAs) serve as potential diagnostic biomarkers in many diseases. However, the role of circRNAs in steroid-induced osteonecrosis of the femoral head (SONFH) has not been reported. Methods. Secondary sequencing was performed to profile circRNA expression in peripheral blood samples from three SONFH patients and three healthy individuals. We confirmed our preliminary findings by qRT-PCR. Bioinformatics analysis was conducted to predict their functions. Results. The result showed 345 dysregulated circRNAs. qRT-PCR of eight selected circRNAs preliminarily confirmed the results, which were consistent with RNA sequencing. Bioinformatics analyses were performed to predict the functions of circRNAs to target the genes of miRNAs and the networks of circRNA-miRNA-mRNA interactions. Conclusions. This study provides a new and fundamental circRNA profile of SONFH and a theoretical basis for further studies on the functions of circRNAs in SONFH.

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“…Its use in orthopaedics began early within decade as PRP was used with bone grafts to augment spinal fusion and fracture healing [19]. Van et al reported that the use of PRP could relieve the pain and halted the disease progression of patients with ONFH [20]. Currently, increasing experimental and clinical evidences showed that PRP may play an effective role in ONFH treatment [21,22].…”

Section: Introductionmentioning

confidence: 99%

The management of platelet-rich plasma in ONFH treatment: A systematic review

Han¹,

Gao²,

Sun³

et al. 2019

Preprint

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Background: Osteonecrosis of femoral head (ONFH) is a pathologic process characterized by the lacking vessel blood of femoral head leading to cellular death, fracture, and collapse of the articular surface. Currently, critical treatment for early stage ONFH is limited to core decompression. However, the efficacy of core decompression remains controversial. With the purpose to improve the core decompression efficacy, regenerative techniques like platelet-rich plasma (PRP) have been proposed to address early stage ONFH. PRP is defined as a sample of autologous blood with concentrations of platelets above baseline values, which have an important role in tissue repair, regeneration, and differentiation of mesenchymal stem cells (MSCs). Within this review, we will present a comprehensive overview of operation modes, mechanism and efficacy of PRP for early stage ONFH treatment. Methods: We searched Pubmed, Embase, Web of Science databases for relevant studies. Any observational or experimental studies that evaluated PRP, MSC, core decompression and ONFH were our goal of searching the electric database. Results: 17 studies that researched PRP and ONFH were identiﬁed in this review. We reviewed 10 studies related to the possible mechanism of PRP for treating ONFH. On the other hand, 7 studies were about to the operation modes of PRP in treating ONFH so far. We reviewed the efficacy of PRP in treating ONFH systematically, with an attempt to make a comparison of PRP operation modes of 7 studies and other operation modes of past studies in early stage ONFH treatment. Conclusion: PRP works to treat ONFH mainly through three mechanisms: induce angiogenesis and osteogenesis to accelerating bone healing; inhibit inflammatory reaction in necrosis lesion; prevents apoptosis induced by glucocorticoid. In addition, PRP are recommended as an adjunctive therapy for core decompression to improve the treatment of early stage ONFH patients, especially combined with stem cells and bone graft to induce an osteogenic activity and stimulate differentiation of stem cell in necrosis lesion.

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Osteonecrosis of the Femoral Head

Cited by 38 publications

References 9 publications

Chinese herbal Huo-Gu formula for the treatment of steroid-associated osteonecrosis of femoral head: A 14-year follow-up of convalescent SARS patients

Chinese herbal Huo-Gu formula for the treatment of steroid-associated osteonecrosis of femoral head: A 14-year follow-up of convalescent SARS patients

Expression Profile Analysis of Differentially Expressed Circular RNAs in Steroid-Induced Osteonecrosis of the Femoral Head

The management of platelet-rich plasma in ONFH treatment: A systematic review

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