Shoulder Osteonecrosis: Pathogenesis, Causes, Clinical Evaluation, Imaging, and Classification

Hernigou, Philippe; Hernigou, Jacques; Scarlat, Marius M.

doi:10.1111/os.12788

Cited by 48 publications

(52 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The interval in our patient between resolution of active infection and avascular necrosis was 8 months. Osteonecrosis as an indication accounts for only 5% of shoulder arthroplasty cases [13] . The challenge is the younger age at which patients with atraumatic osteonecrosis present, given the limited lifespan of the prosthesis, and a need for later revision [13] .…”

Section: Discussionmentioning

confidence: 99%

“…Osteonecrosis as an indication accounts for only 5% of shoulder arthroplasty cases [13] . The challenge is the younger age at which patients with atraumatic osteonecrosis present, given the limited lifespan of the prosthesis, and a need for later revision [13] . Patients presenting with late-stage disease (Cruess IV and V), invariably have progression, necessitating arthroplasty [14] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral glenohumeral septic arthritis secondary to mastitis with subsequent avascular necrosis: A case report

Maranya

Mutiso

2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Introduction and importance Septic arthritis is an orthopaedic emergency. Only 3% of septic arthritis patients present with glenohumeral involvement. Polyarticular disease with shoulder involvement constitutes 1% of this group. There is currently no documented case of bilateral glenohumeral septic arthritis with avascular necrosis secondary to mastitis. Case presentation We present a case of a 38-year-old African woman with bilateral glenohumeral septic arthritis after management for mastitis of the left breast. She had left, then right shoulder pain, fever, and reduced range of motion, with multiple arthroscopic washouts and antibiotic therapy instituted at various hospitals by various specialists, leading to the resolution of active infection. The patient developed bilateral humeral head avascular necrosis with complete collapse as evidenced on plain radiography 4 months later, and underwent hemiarthroplasty of the right shoulder. Biopsy at operation showed no active bone infection, and inflammatory markers were not elevated. She had reduced discomfort for the following 2 years but developed increasing pain on lifting and reduced range of motion. The moderate symptoms in her left shoulder managed non-operatively had remained unchanged. There were no elevated inflammatory markers 2-years post arthroplasty. Clinical discussion This case presents an uncommon scenario of bilateral septic arthritis secondary to mastitis, with rapid progression to avascular necrosis in an individual with no classical risk factors for avascular necrosis, despite appropriate antibiotic treatment and surgical interventions. Advanced collapse necessitated hemiarthroplasty of the dominant right side. Conclusion This case highlights the need for close radiographic follow-up in atypical presentations of septic arthritis and the dilemmas in managing advanced bilateral avascular necrosis with arthroplasty in a young patient.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bilateral glenohumeral septic arthritis secondary to mastitis with subsequent avascular necrosis: A case report

Maranya

Mutiso

2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…Rapidly destructive osteonecrosis (RDON) of the humeral head is a well-known complication that has been reported to occur due to trauma, use of corticosteroids, autosomal recessive disorders such as sickle cell anemia, alcohol and dysbarism [ 1 , 2 ]. However, RDON occurs very rarely after arthroscopic rotator cuff repair (RCR), while it is a severe complication leading to poor clinical outcome without postoperative recovery [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Rapidly destructive osteonecrosis of the humeral head after arthroscopic rotator cuff repair: a case report

Kim

2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Cases of rapidly destructive osteonecrosis (RDON) of the humeral head after arthroscopic rotator cuff repair (RCR) have rarely been reported, which has prevented a clear consensus on the cause of osteonecrosis. Case presentation A 63-year-old woman without a history of trauma underwent arthroscopic RCR after being diagnosed with a medium-sized full-thickness rotator cuff tear for symptoms of left shoulder pain for six months. The patient had no medical history other than hypertension, and no other potential cause was found for osteonecrosis of the left shoulder prior to surgery. Four months after surgery, pain and range of motion improved. Six months after surgery, the patient complained of an increase in shoulder pain. While follow-up ultrasonography did not show a re-tear of the repaired tendon, osteonecrosis of the humeral head could not be confirmed as plain radiography was not performed. Follow up MRI performed a year after surgery revealed RDON of the humeral head. Despite mild improvement in the shoulder pain, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA) and Constant score were poor at 23 and 69, respectively. In the present case, the arthroscopic RCR was performed using two anchors; for the repair of the anterior of the supraspinatus and the rotator interval, a 2.8-mm all-suture anchor was inserted into the upper part of the intertubercular groove. The cause of RDON is presumed to be the damage to the anterolateral and intraosseous branches of the anterior humeral circumflex artery (AHCA) for anchor positioning and insertion. Conclusions A poor outcome was obtained in the case of RDON, despite the integrity of the repaired rotator cuff tendon after arthroscopic RCR was intact. Although the cause of RDON has not been clearly established, care should be taken not to damage the anterolateral and intraosseous branches of the AHCA regarding the insertion location of the suture anchor, and to prepare the anchor in the vicinity of the intertubercular groove.

show abstract

“…Ineffective repairs such as fibrous tissue repair cannot replace the original bone tissue in terms of structure and support performance. Therefore, osteonecrosis involving joints often leads to the gradual collapse of the articular surface, which in turn causes arthritis (Calder et al, 2001;Hernigou et al, 2020;Cui et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Polymer Scaffolds-Enhanced Bone Regeneration in Osteonecrosis Therapy

Dong

Zhu

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Osteonecrosis without effective early treatment eventually leads to the collapse of the articular surface and causes arthritis. For the early stages of osteonecrosis, core decompression combined with bone grafting, is a procedure worthy of attention and clinical trial. And the study of bone graft substitutes has become a hot topic in the area of osteonecrosis research. In recent years, polymers have received more attention than other materials due to their excellent performance. However, because of the harsh microenvironment in osteonecrosis, pure polymers may not meet the stringent requirements of osteonecrosis research. The combined application of polymers and various other substances makes up for the shortcomings of polymers, and to meet a broad range of requirements for application in osteonecrosis therapy. This review focuses on various applying polymers in osteonecrosis therapy, then discusses the development of biofunctionalized composite polymers based on the polymers combined with different bioactive substances. At the end, we discuss their prospects for translation to clinical practice.

show abstract

Shoulder Osteonecrosis: Pathogenesis, Causes, Clinical Evaluation, Imaging, and Classification

Cited by 48 publications

References 29 publications

Bilateral glenohumeral septic arthritis secondary to mastitis with subsequent avascular necrosis: A case report

Bilateral glenohumeral septic arthritis secondary to mastitis with subsequent avascular necrosis: A case report

Rapidly destructive osteonecrosis of the humeral head after arthroscopic rotator cuff repair: a case report

Polymer Scaffolds-Enhanced Bone Regeneration in Osteonecrosis Therapy

Contact Info

Product

Resources

About