Summary of the various treatments for osteonecrosis of the femoral head by mechanism: A review

Wang, Cheng; Peng, Jiang; Lu, Shibi

doi:10.3892/etm.2014.1811

Cited by 57 publications

(54 citation statements)

References 76 publications

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“…About 10 % of all THR are implanted due to progressed ONFH, and so ONFH has a high socioeconomic relevance [4]. Smoking, excessive alcohol consumption, infections, hyperbaric events, lipid metabolic disorder, coagulation defects or corticosteroid intake can also lead to ONFH [5,6].…”

Section: Introductionmentioning

confidence: 99%

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Floerkemeier

Budde

Gronewold

et al. 2015

Arch Orthop Trauma Surg

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The short- to medium-term results show predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed osseointegration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the ostenecrosis exceeds the femoral neck.

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Section: Introductionmentioning

confidence: 99%

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Floerkemeier

Budde

Gronewold

et al. 2015

Arch Orthop Trauma Surg

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“…[24][25][26][27] In early stage osteonecrosis, the structure of the femoral head begins to change. 28 subchondral bone continuity is altered, and articular cartilage separation can manifest.…”

Section: Discussionmentioning

confidence: 99%

Microstructure and Nanomechanical Properties of Single Trabecular Bone in Different Regions of Osteonecrosis of the Femoral Head

Wang¹,

Wang²,

Meng³

et al. 2016

j nanosci nanotechnol

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This study aimed to compare the microstructure and nanomechanical properties of single trabecular bone in different regions of osteonecrosis of the femoral head. Osteonecrotic femoral heads were taken from 20 patients undergoing total hip arthroplasties between 2011 and 2014. Following incision, resin was embedded and polished, and divided into four regions according to the type of pathologic change; i.e., subchondral bone, and necrotic, sclerotic, and healthy regions. Indents from a single trabecular bone of each region were randomly selected to undergo nanoindentation. The results are (1) The elastic modulus and degree of hardness were significantly elevated in the sclerotic region, but there were no differences in necrotic and subchondral bone regions compared with healthy regions. (2) The elastic modulus and hardness of the single trabecular bone were significantly greater in central versus edge regions (for all regions). The conclusions are (1) The mechanical properties of single bone trabeculae were not markedly altered in the necrotic region. (2) The elastic modulus and degree of hardness increased significantly between the edge and central regions, regardless of whether the bone was normal or osteonecrotic.

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“…Such pathology is frequently observed in relatively young adults, and most of the untreated patients with ONFH progress to total hip arthroplasty (THA) with a collapse rate of 67% and 85% in asymptomatic and symptomatic patients, respectively [5]. …”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Outcomes of Extracorporeal Shock Wave Therapy in Early-Stage Femoral Head Osteonecrosis

Algarni

Moallem

2018

Advances in Orthopedics

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Objective Femoral head osteonecrosis is a progressive clinical condition with significant morbidity and long-term disability. Several treatment modalities including both surgical and nonsurgical options have been used with variable levels of success. High-energy extracorporeal shock wave therapy is a nonoperative treatment option that has been described for early-stage disease. We aimed to assess the functional and radiological outcomes of extracorporeal shockwave therapy (ESWT) in the treatment of osteonecrosis of the femoral head (ONFH). Methods Thirty-three hips of 21 patients were included in this study. Adult patients with ONFH of any etiology and in the precollapse stage were included. Clinical (visual analogue scale [VAS] and Harris hip score [HHS]) and radiological (plain radiographs and magnetic resonance imaging [MRI]) evaluations were performed before and after intervention. We used 3000–4500 pulses in a single session performed under general anesthesia. Results At an average of 8 months after ESWT, pain scores and HHS were significantly improved compared with the preintervention scores (p<0.001). The overall clinical outcomes were improved in 21 hips (63.3%), unchanged in 5 hips (15.15%), and worsened in 7 hips (21.2%). A trend toward a decrease in the size of the ONFH was observed although not of clinical significance (p=0.235). MRI revealed significant resolution of bone marrow edema (p<0.003). Regression was observed in 9 lesions (42.9%) and progression in 1 lesion (4.7%); no change was observed in the remaining 23 lesions (52.4%). Conclusion ESWT is a viable noninvasive treatment option for early-stage ONFH. It significantly improves clinical outcomes and may halt or delay the radiographic progression of the disease in the precollapse stage.

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Summary of the various treatments for osteonecrosis of the femoral head by mechanism: A review

Cited by 57 publications

References 76 publications

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Short-stem hip arthroplasty in osteonecrosis of the femoral head

Microstructure and Nanomechanical Properties of Single Trabecular Bone in Different Regions of Osteonecrosis of the Femoral Head

Clinical and Radiological Outcomes of Extracorporeal Shock Wave Therapy in Early-Stage Femoral Head Osteonecrosis

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