Treatment of osteonecrosis of the femoral head with vascularized bone grafting

Millikan, Patrick D.; Karas, Vasili; Wellman, Samuel S.

doi:10.1007/s12178-015-9285-8

Cited by 24 publications

(18 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For vascularized bone grafting, the fibula or iliac crest graft supports the subchondral bone with a viable, strong bone strut and enhances the revascularization of the femoral head. Free vascularized bone grafting is technically demanding, requires expertise in microsurgery, and is associated with donor site morbidity (Figures 7 - 8 ) [ 16 ].…”

Section: Reviewmentioning

confidence: 99%

Osteonecrosis of the Femoral Head: Etiology, Investigations, and Management

Baig¹,

Baig²

2018

Cureus

View full text Add to dashboard Cite

show abstract

Section: Reviewmentioning

confidence: 99%

Osteonecrosis of the Femoral Head: Etiology, Investigations, and Management

Baig¹,

Baig²

2018

Cureus

View full text Add to dashboard Cite

show abstract

“…It has been reported that between 5 and 40% of patients treated with long-term GC develop ON [3], and between 30 and 50% of patients develop GC-induced secondary osteoporosis [4]. In addition, GC-induced ON of the femoral head increases the risk of fractures and may lead to femoral head collapse, which often requires surgical treatments including total hip arthroplasty, bone grafting and osteotomy [2], [5], [6], [7]. Therefore, preclinical models of GC-induced ON that resemble the human pathology are useful for the development of novel and effective treatment modalities for patients with the disease.…”

Section: Introductionmentioning

confidence: 99%

Strain-specific differences in the development of bone loss and incidence of osteonecrosis following glucocorticoid treatment in two different mouse strains

Shidara

Mohan

Lay

et al. 2019

Journal of Orthopaedic Translation

View full text Add to dashboard Cite

ObjectiveGlucocorticoids (GCs) are commonly prescribed as treatment for chronic inflammatory diseases. Prolonged use of GCs is a common cause of atraumatic osteonecrosis (ON) and secondary osteoporosis. Currently, there is no effective treatment for this disease; therefore, a reliable animal model would be useful to study both the pathology and novel treatment strategies for patients with the disease. The aim of this study was to establish a validated, reproducible model of GC-induced ON and bone loss in two different mouse strains (BALB/c and C57BL/6).MethodsSeven-week-old male BALB/c (n = 32) and male C57BL/6 mice (n = 32) were randomised into placebo or GC groups and treated with daily 4 mg/L oral dexamethasone in drinking water for 90 days. Study outcome measures included histologic assessment of ON of the distal femur, bone mass and mechanical strength of tibia and lumbar vertebral body, osteoclast number, biochemical measure of bone formation and bone marrow fat quantitation.ResultsGC-induced ON lesions were observed in the distal femur in 47% of the male BALB/c mice and 25% of the male C57BL/6 mice. GC treatment decreased the trabecular bone volume and serum pro-collagen type 1N-protease (P1NP) in BALB/c mice compared with the placebo (p < 0.05) and reduced tibial bone strength in both BALB/c and C57BL/6 mice. GC-treated BALB/c mice had significantly greater marrow fat levels compared to the placebo group.ConclusionGC-induced ON was more prevalent in the male BALB/c mice compared to the male C57BL/6 mice. GC treatment significantly reduced bone mass, bone formation measured by P1NP, bone strength and increased marrow fat levels in male BALB/c mice. Therefore, the use of male BALB/c mice strain is recommended for both diagnostic and therapeutic studies for the prevention and treatment of ON and bone loss following prolonged treatment with GCs.The Translational Potential of this ArticleGCs are commonly used to treat patients with various chronic inflammatory diseases, and this is associated with both the development of ON and bone loss. Our study confirmed that the BALB/c mouse strain treated for 90 days with GC may be useful for developing novel treatments for ON.

show abstract

“…Currently, hip-preserving surgeries for ONFH mainly included core-decompression [9,10], vascularized or non-vascularized bone grafting [1,6,11,12], and osteotomy of the femur or acetabulum [13][14][15]. Hip-preserving surgery with vascularized pedicle iliac bone grafting (VPIBG) is an effective treatment for ONFH, which can reduce the intraosseous pressure, promote the revascularization of ischemic areas, provide structural support to prevent collapse [5,[16][17][18], and can be easily implemented without microsurgery techniques.…”

Section: Introductionmentioning

confidence: 99%

How long does a hip-preserving surgery with vascularized pedicle iliac bone grafts for femur head necrosis last? A systematic review and meta-analysis of case series with an average more than 5-year follow-up

Zhu

Zhang

Sun

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Hip-preserving surgeries with vascularized pedicle iliac bone grafts (VPIBG) are effective for osteonecrosis of the femoral head (ONFH). However, few studies exist about the long-term efficacy of this procedure. The aim of this meta analysis was to investigate how long does this hip-preserving surgery last. Methods: A comprehensive search was carried out through PubMed, Embase and Cochrane Collaboration Library for all relevant studies up to November 2019. The literature search strategy contained Medical Subject Headings and terms relating to ONFH and bone transplantation. All included studies were articles on VBIPG for ONFH, with an average follow-up of more than 5 years. Interesting outcomes included clinical success rates, complications, and conversion rates of THA. The data from eligible studies were then extracted and synthesized. The pooled effect size (ES) and 95% confidence intervals (CIs) were calculated. Results: Ten studies were finally selected. Eight studies including 3413 hips were pooled into the meta-analysis of success rates, the overall ES was 0.89 (95% CI, 0.86–0.92). In subgroup analysis, the ES was 0.88 (95% CI, 0.78–0.98) and 0.90 (95% CI, 0.87–0.92) at an average 5-10 years and 10-15 years follow-up, respectively. Pooled analysis of THA conversion rates derived from 7 studies (3389 hips) showed the overall ES of 0.10 (95% CI, 0.09–0.11). Seven studies (3396 hips) were included in a meta-analysis of complication rates, and the overall ES was 0.12 (95% CI, 0.08–0.18). The most common complications were secondary wound healing (37.6%), numbness or paresthesia of the lateral thigh (22.4%), and deep vein thrombosis (19.6%). Conclusions: The hip-preserving surgery with VPIBG is a safe and effective treatment for early-stage ONFH, but it should be used with caution in the treatment of advanced femoral head necrosis. The pooled data from this study suggested that 90% of the hips in patients with ONFH lasted 10 years after this surgery. However, most of the included studies are case series, and these conclusions will need the support of high-quality research in the future.

show abstract

Treatment of osteonecrosis of the femoral head with vascularized bone grafting

Cited by 24 publications

References 42 publications

Osteonecrosis of the Femoral Head: Etiology, Investigations, and Management

Osteonecrosis of the Femoral Head: Etiology, Investigations, and Management

Strain-specific differences in the development of bone loss and incidence of osteonecrosis following glucocorticoid treatment in two different mouse strains

How long does a hip-preserving surgery with vascularized pedicle iliac bone grafts for femur head necrosis last? A systematic review and meta-analysis of case series with an average more than 5-year follow-up

Contact Info

Product

Resources

About