Selective reduction of bone blood flow by short-term treatment with high-dose methylprednisolone

Drescher, Wolf; Schneider, Thomas; Becker, Cordelia; Hobolth, J.; Rüther, W.; Hansen, Ebbe Stender; Bünger, Cody

doi:10.1302/0301-620x.83b2.0830274

Cited by 18 publications

(10 citation statements)

References 21 publications

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“…We also found a lower F H blood flow after 2 week high dose methylprednisolone treatment in the anesthetized pig where F H epiphyseal blood flow was 13.4 +_ 1.7 ml * 100 g tissue-' min-' in the control animals and 5.1 +_ 0.6 ml* 100 g tissue-' min-' in the steroid treated group [8]. As after 2 week high dose steroid treatment, F H epiphyseal blood flow was reduced globally without a prevailing tendency of any of the subregions to prominent decrease in blood flow.…”

Section: Phasesupporting

confidence: 57%

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Femoral head blood flow reduction and hypercoagulability under 24 h megadose steroid treatment in pigs

DRESCHER¹

2004

Journal of Orthopaedic Research

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The pathogenesis of corticosteroid-induced femoral head necrosis is assumed to be ischemia. The purpose of this study was to investigate the perfusion pattern of the femoral head and plasma coagulability during 24 h corticosteroid megadose treatment, as recommended by the National Acute Spinal Cord Injury Studies (NASCIS), in the awake big animal model. Blindedly, 9 animals underwent megadose methylprednisolone infusion (30 mg/kg intravenously as a n initial bolus, followed by 5.4 mglkglh for further 23 h) while 9 animals served as placebo treated controls. Regional blood flow of the systematically subdivided femoral head, proximal femur, acetabulum, and soft tissue hip regions was investigated by the microsphere technique at steady state (phase I), after the initial bolus infusion (phase 2), and after the completed treatment (phase 3). Plasma coagulability was examined in phases 1 and 3. Blood flow of the femoral head epiphysis and metaphyseal cancellous bone was unchanged after one hour of steroid infusion, but decreased after the completed treatment at 24 h in the experimental group. Femoral head blood flow reduction was global without a tendency to more pronounced blood flow decrease in any subregion. Plasma fibrinogen was significantly higher after 24 h of steroid infusion than in the placebo control group. 24 h high dose methylprednisolone treatment causes femoral head blood flow reduction and hypercoagulability of plasma in the normal awake immature pig. These findings may be pathogenetic factors in the early stage of steroid-induced osteonecrosis.

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Section: Phasesupporting

confidence: 57%

“…The total dosage of a mean 9090 mg (range 8446-9936 mg) methylprednisolone in the test group of animals was reached by strictly following the NASCIS protocol and is thereby huge, but clinically relevant. This dosage compares to the total dosage given to pigs over a 2 week period and led to 2-3 fold F H blood flow reduction [8].…”

Section: Phasementioning

confidence: 88%

Femoral head blood flow reduction and hypercoagulability under 24 h megadose steroid treatment in pigs

DRESCHER¹

2004

Journal of Orthopaedic Research

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“…Femoral muscle perfusion is reported to range from 3 to 17 ml Á min -1 per 100 g at rest [28][29][30][31]. In contrast, perfusion to the femoral bone is reported to range from 11 to 40 ml Á min -1 per 100 g [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Localized internal radiotherapy with 90Y particles embedded in a new thermosetting alginate gel: A feasibility study in pigs

Holte¹,

Skretting²,

Bach‐Gansmo³

et al. 2006

Nuclear Medicine Communications

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“…This technique is well established for determining regional bone blood flow. 2,17,18,23,27,29,31,33,39 However, validation of radioactive or fluorescent microspheres for measurement of regional bone blood flow is incomplete. When microspheres are used for determination of organ blood flow, several assumptions, limitations, and some technical prerequisites of the microsphere technique need to be considered in an adequate experimental setup.…”

Section: Discussionmentioning

confidence: 99%

Microspheres Accurately Predict Regional Bone Blood Flow

Anetzberger¹,

Thein²,

Becker³

et al. 2004

Clinical Orthopaedics &Amp; Related Research

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Even though the microsphere method frequently is used to determinate bone blood flow, validation of this technique for bone blood flow measurement is incomplete. The method is based on the principle that injected microspheres are distributed with the arterial blood and trapped in the capillaries because of their diameter (15 µm). The number of spheres lodged in an organ is proportional to its blood flow. The number of radioactive or fluorescent microspheres in a specific organ is determined indirectly by measuring radioactivity or fluorescence intensity in the organ. In this study the reliability and precision of the microsphere method for determining bone blood flow was established using radioactive and fluorescent microspheres. Six female, anesthetized New Zealand rabbits received left ventricular injections of pairs of fluorescent and/or radioactive microspheres. The humerus, femur, and tibia were dissected in a standardized manner and blood flow was determined in each sample. Comparison of relative blood flow values showed an excellent correlation between radioactive and fluorescent microspheres. The percentage difference and variation between two simultaneously injected sets of microspheres was minimal for radioactive microspheres (0.8% ± 9.6%) and for fluorescent microspheres (0.2% ± 11.4%). Regional bone blood flow in different regions of the femur, tibia, or humerus ranged from 2.2-28.1 mL/minute/100 g, but there was no significant difference between right and left bone samples of the same region after repeated measurement. Radioactive and fluorescent microspheres allow precise determination of regional bone blood flow.

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Selective reduction of bone blood flow by short-term treatment with high-dose methylprednisolone

Cited by 18 publications

References 21 publications

Femoral head blood flow reduction and hypercoagulability under 24 h megadose steroid treatment in pigs

Femoral head blood flow reduction and hypercoagulability under 24 h megadose steroid treatment in pigs

Localized internal radiotherapy with 90Y particles embedded in a new thermosetting alginate gel: A feasibility study in pigs

Microspheres Accurately Predict Regional Bone Blood Flow

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