Advances in experimental models of osteonecrosis of the femoral head

Li, Fulin; Shao, Wenkai; Lv, Xiao Ling; Wang, Bo; Han, Lizhi; Gong, Song; Wang, Ping; Feng, Yong

doi:10.1016/j.jot.2023.01.003

Cited by 17 publications

(11 citation statements)

References 148 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…However, the patient's hip pain symptoms were relieved after surgical joint cleaning, so we speculated that ONFH might be a total joint disease. In the early and middle stages of ONFH, there are extra‐articular lesions of the femoral head itself and intraarticular synovial hyperplasia and cartilage destruction, which work together to accelerate the necrosis of the femoral head 32 . Femoral head necrosis has both internal and external factors, so it is necessary to deal with both internal and external joint lesions in order to achieve satisfactory curative effect.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to arthroscopic treatment of intraarticular lesions, we also applied MSFLD decompression technology to overcome the shortcomings of traditional core decompression drilling with large diameter, insufficient subchondral bone support, accelerated collapse of the femoral head and peripheral fractures. Advantages of MSFLD are: (1) multiple drilling holes with small diameters provide a cumulative decompression area that is not inferior to CD, with equivalent or better decompression effects 31 , 32 ; (2) distribution of the decompression channels in a fan‐shaped pattern reaches any necrotic area while minimizing bone loss and preserving supportive structures between bone channels, thus effectively preventing femoral head collapse after decompression 33 ; (3) low‐speed drilling does not generate high heat, avoiding thermal damage to the cancellous bone caused by frictional heat. 29 , 34 Li et al 6 performed MSFLD on ARCO stage I‐II ONFH patients using the narrow‐diameter multi‐channel decompression method, and they observed significant improvements in all indicators compared to advanced‐stage disease, including treatment efficacy, collapse rate of subchondral bone, lesion size, marrow edema grading, Harris score, visual analog scale for pain, and other indicators.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Hip Arthroscopy Debridement Combined with Multiple Small‐Diameter Fan‐Shaped Low‐Speed Drilling Decompression in the Treatment of Early and Middle Stage Osteonecrosis of the Femoral Head: 14 Years Follow‐Up

Zhao,

Liu,

Zheng

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveOsteonecrosis of the femoral head (ONFH) is a disease that occurs frequently in young and middle‐aged people. Because of its high disability rate, it affects the ability to work, so the early treatment of this disease is particularly important. This retrospective study aimed to evaluate the clinical efficacy of hip arthroscopy combined with multiple small‐diameter fan‐shaped low‐speed drilling decompression (MSFLD) in treating early‐mid stage ONFH (ARCO II‐IIIA) compared to MSFLD, with at least 10‐year follow‐up.MethodsA total of 234 patients who underwent hip arthroscopy and MSFLD for ONFH from 1998 to 2012 were analyzed retrospectively. This study enrolled patients between 18 and 60 years old with ARCO stage II‐III A, diagnosed clinically and through imaging, in accordance with the 2021 guidelines for the treatment of ONFH. Clinical data, including demographics, operation mode, BMI, pre‐ and postoperative Harris score, and femoral head survival rate, were collected. Patients were divided into hip arthroscopy + MSFLD and MSFLD groups based on the operation mode. The t‐test was used to compare the postoperative efficacy, Harris scores, and survival rates of the femoral head between the two groups.ResultsAmong the 234 patients, 160 cases were followed up, including 92 cases in the hip arthroscopy + MSFLD group and 68 cases in MSFLD group, the follow‐up rate was 68.38%, and the follow‐up time was (10–22)14.11 ± 3.06 years. The Harris score (80.65 ± 6.29) in the hip arthroscopy + MSFLD group was significantly higher than that in the MSFLD group (p = 0.00), and the survival rate of femoral head (5‐year survival rate was 84.78%, 10‐year survival rate was 23.91%) was also higher than that in the MSFLD group (5‐year survival rate was 63.24%, 10‐year survival rate was 8.82%). The 5‐year and 10‐year survival rates of patients with ARCO II were 82.11% and 28.42%, which were better than 54% and 33% for ARCO III A. The femur head survival rate of alcoholic ONFH (5‐year survival rate 61.54%, 10‐year survival rate 9.23%) was significantly higher than that of other types of ONFH.ConclusionClinical follow‐up of at least 10 years suggests that hip arthroscopy combined with MSFLD is an effective treatment for early‐mid stage ONFH, with good clinical effect and high survival rate of femoral head.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hip Arthroscopy Debridement Combined with Multiple Small‐Diameter Fan‐Shaped Low‐Speed Drilling Decompression in the Treatment of Early and Middle Stage Osteonecrosis of the Femoral Head: 14 Years Follow‐Up

Zhao,

Liu,

Zheng

et al. 2024

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…An appropriate experimental model of the human disease is a prerequisite for a clinical trial to assess the efficacy and safety of a novel treatment model in the setting of ONFH [ 1 ]. From this context, an animal model of ONFH played a key role in performing a pre-clinical trial to identify more effective treatments, whereas a cellular model was used to clarify the pathogenesis and pathophysiology of ONFH [ 50 ]. Nevertheless, many experimental models do not share the same physiological and metabolic characteristics with humans [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Experiment to Measure the Initial Mechanical Stability of the Femoral Head Implant in a Cadaveric Model of Osteonecrosis of Femoral Head Involving up to 50% of the Remaining Femoral Head

2023

View full text Add to dashboard Cite

Background and Objectives: Currently, only patients with osteonecrosis of the femoral head (ONFH), who had bone defects involving 30–33.3% of the remaining femoral head, are indicated in hip resurfacing arthroplasty (HRA). In an experimental cadaver model of ONFH involving up to 50% of the remaining femoral head, the initial stability of the femoral head implant (FHI) at the interface between the implant and the remaining femoral head was measured. Materials and Methods: The ten specimens and the remaining ten served as the experimental group and the control group, respectively. We examined the degree of the displacement of the FHI, the bonding strength between the FHI and the retained bone and that at the interface between the FHI and bone cement. Results: Changes in the degree of displacement at the final phase from the initial phase were calculated as 0.089 ± 0.036 mm in the experimental group and 0.083 ± 0.056 mm in the control group. However, this difference reached no statistical significance (p = 0.7789). Overall, there was an increase in the degree of displacement due to the loading stress, with increased loading cycles in both groups. In cycles of up to 6000 times, there was a steep increase. After cycles of 8000 times, however, there was a gradual increase. Moreover, in cycles of up to 8000 times, there was an increase in the difference in the degree of displacement due to the loading stress between the two groups. After cycles of 8000 times, however, such difference remained almost unchanged. Conclusions: In conclusion, orthopedic surgeons could consider performing the HRA in patients with ONFH where the bone defects involved up to 50% of the remaining femoral head, without involving the femoral head–neck junction in the anterior and superior area of the femoral head. However, more evidence-based studies are warranted to justify our results.

show abstract

“…However, the underlying molecular mechanisms of glucocorticoid-induced FH diseases are still unelucidated. Fat embolism, vascular thrombosis, osteocyte apoptosis, and oxidative stress contribute to steroid-induced osteonecrosis in the femoral head [138]. The protective effects of naringin on steroid-induced avascular necrosis of the femoral head (SANFH) have been investigated.…”

Section: The Protective Activities Of Naringin Against Femoral Head (...mentioning

confidence: 99%

The Development of Naringin for Use against Bone and Cartilage Disorders

Gan

Deng

et al. 2023

Molecules

View full text Add to dashboard Cite

Bone and cartilage disorders are the leading causes of musculoskeletal disability. There is no absolute cure for all bone and cartilage disorders. The exploration of natural compounds for the potential therapeutic use against bone and cartilage disorders is proving promising. Among these natural chemicals, naringin, a flavanone glycoside, is a potential candidate due to its multifaceted pharmacological activities in bone and cartilage tissues. Emerging studies indicate that naringin may promote osteogenic differentiation, inhibit osteoclast formation, and exhibit protective effects against osteoporosis in vivo and in vitro. Many signaling pathways, such as BMP-2, Wnt/β-catenin, and VEGF/VEGFR, participate in the biological actions of naringin in mediating the pathological development of osteoporosis. In addition, the anti-inflammatory, anti-oxidative stress, and anti-apoptosis abilities of naringin also demonstrate its beneficial effects against bone and cartilage disorders, including intervertebral disc degeneration, osteoarthritis, rheumatoid arthritis, bone and cartilage tumors, and tibial dyschondroplasia. Naringin exhibits protective effects against bone and cartilage disorders. However, more efforts are still needed due to, at least in part, the uncertainty of drug targets. Further biological and pharmacological evaluations of naringin and its applications in bone tissue engineering, particularly its therapeutic effects against osteoporosis, might result in developing potential drug candidates.

show abstract

Advances in experimental models of osteonecrosis of the femoral head

Cited by 17 publications

References 148 publications

Hip Arthroscopy Debridement Combined with Multiple Small‐Diameter Fan‐Shaped Low‐Speed Drilling Decompression in the Treatment of Early and Middle Stage Osteonecrosis of the Femoral Head: 14 Years Follow‐Up

Hip Arthroscopy Debridement Combined with Multiple Small‐Diameter Fan‐Shaped Low‐Speed Drilling Decompression in the Treatment of Early and Middle Stage Osteonecrosis of the Femoral Head: 14 Years Follow‐Up

A Pilot Experiment to Measure the Initial Mechanical Stability of the Femoral Head Implant in a Cadaveric Model of Osteonecrosis of Femoral Head Involving up to 50% of the Remaining Femoral Head

The Development of Naringin for Use against Bone and Cartilage Disorders

Contact Info

Product

Resources

About