Avascular Necrosis of the Femoral Head

Seijas, Roberto; Sallent, Andrea; Rivera, Eila; Ares, Óscar

doi:10.1080/08941939.2017.1398282

Cited by 20 publications

(14 citation statements)

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“…Avascular necrosis of femoral head (ANFH) is a disease that is related to necrosis of bone cells and marrow tissue, structural changes and collapse of the femoral head, joint dysfunction and pain ( Seijas et al, 2017 ). ANFH is a slow-course disease with complex etiology and a high disability rate, leading to the loss of a patient’s physical labor ability ( Zalavras and Lieberman, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Cryogenic 3D Printing of ß-TCP/PLGA Composite Scaffolds Incorporated With BpV (Pic) for Treating Early Avascular Necrosis of Femoral Head

Feng

Cao

et al. 2022

Front. Bioeng. Biotechnol.

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Avascular necrosis of femoral head (ANFH) is a disease that is characterized by structural changes and collapse of the femoral head. The exact causes of ANFH are not yet clear, but small advances in etiopathogenesis, diagnosis and treatment are achieved. In this study, ß-tricalcium phosphate/poly lactic-co-glycolic acid composite scaffolds incorporated with bisperoxovanadium [bpV (pic)] (bPTCP) was fabricated through cryogenic 3D printing and were utilized to treat rat models with early ANFH, which were constructed by alcohol gavage for 6 months. The physical properties of bPTCP scaffolds and in vitro bpV (pic) release from the scaffolds were assessed. It was found that the sustained release of bpV (pic) promoted osteogenic differentiation and inhibited adipose differentiation of bone marrow-derived mesenchymal stem cells. Micro-computed tomography scanning and histological analysis confirmed that the progression of ANFH in rats was notably alleviated in bPTCP scaffolds. Moreover, it was noted that the bPTCP scaffolds inhibited phosphatase and tensin homolog and activated the mechanistic target of rapamycin signaling. The autophagy induced by bPTCP scaffolds could partially prevent apoptosis, promote osteogenesis and angiogenesis, and hence eventually prevent the progression of ANFH, suggesting that the bPTCP scaffold are promising candidate to treat ANFH.

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Section: Introductionmentioning

confidence: 99%

Cryogenic 3D Printing of ß-TCP/PLGA Composite Scaffolds Incorporated With BpV (Pic) for Treating Early Avascular Necrosis of Femoral Head

Feng

Cao

et al. 2022

Front. Bioeng. Biotechnol.

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“…Avascular necrosis of the femoral head is one of the most common diseases in orthopaedics and is associated with a number of complex factors [ 1 ]. Apoptosis of bone cells leads to a gradual collapse of subchondral bone and articular cartilage and eventually collapse of the femoral heads, which causes avascular necrosis of the femoral head [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…For advanced femoral head necrosis, replacement is the preferred method to reconstruct the structure and function of hip joints [ 2 , 3 ]. Since the aetiology and pathogenesis of femoral head necrosis are not fully understood, controversies regarding the choice of treatment methods and the efficacy in different stages persist [ 1 – 3 ]. It is now widely accepted that ischaemia is an important stage and pathologic process in the development of the disease, regardless of pathogenic factors [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Since the aetiology and pathogenesis of femoral head necrosis are not fully understood, controversies regarding the choice of treatment methods and the efficacy in different stages persist [ 1 – 3 ]. It is now widely accepted that ischaemia is an important stage and pathologic process in the development of the disease, regardless of pathogenic factors [ 1 – 3 ]. This important point of view has been confirmed in animal models of femoral head necrosis, in which the arteries supplying the femoral head were ligated [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of ligating dogs’ arteries and veins on femoral heads

et al. 2022

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Background We separately ligated the arteries and veins of dogs to establish a canine femoral head necrosis model, then compared the differences between the outcomes of the two ligation methods on canine femoral heads. Methods Twenty-four dogs in this experiment were randomly and evenly sorted into two groups (Group A, the arterial group; and Group B, the venous group). In dogs in Group A, the unilateral deep femoral arteries of the hips were ligated. In dogs in Group B, the unilateral deep femoral veins of the hips were ligated. Two dogs from each group were randomly selected at the 2nd, 4th, 6th, 8th, 10th, and 12th weeks postoperatively and were marked as Groups A1–A6 and B1–B6 according to the selection times. The dogs underwent X-ray (DR) and a magnetic resonance imaging (MRI) plain scan (1.5 T) on both hip joints and were then sacrificed. Bilateral femoral head specimens were soaked in formalin and then decalcified. Hematoxylin–eosin (HE) staining and histopathologic evaluation were performed on the tissue sections. Results In dogs in Group B, abnormal pathologic changes, such as adipocytes fusing into cysts, were observed at the 4th week after establishing the model. MRI scans showed abnormal signal intensity at the 6th week, and fibrocyte regrowth was demonstrated in the necrotic area of the femoral heads at the 10th week. At the same time, indicators of tissue repair and fresh granulation tissue emerged. Changes in dogs in Group A, such as interstitial haemorrhage and oedema, were not noted in pathologic sections until 6 weeks after the model was established. MRI showed abnormal signals, such as a linear low signal intensity in the weight-bearing area of the femoral heads at the 8th week. New blood vessels emerged in the necrotic area at the 12th week, while there was no proliferation of fibrocytes and tissues. Conclusions The development and evolution of femoral head necrosis caused by ligation of the main veins of the femoral head in dogs appeared earlier than in dogs with arterial ligation, and pathologic changes, such as necrosis and repair, were more significant in dogs in the venous group than in dogs in the other group.

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“…Hip osteonecrosis is the most common of all avascular necrosis, this is because of the disruption of vascular supply to the femoral head. [5,6] Other common ischemic necrosis includes carpal bones, talus, metatarsal bones, mandible bone, and humeral head.…”

Section: Introductionmentioning

confidence: 99%

An overview of the diagnosis and management of Avascular Necrosis

Alruwaili¹,

K.Al-Senan²,

Alkhathami³

et al. 2021

Int j pharm res allied sci

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Introduction: Hip joint necrosis is the most commonly affected joint with avascular necrosis. Other common ischemic necrosis includes carpal bones, talus, metatarsal bones, mandible bone, and humeral head. It is important for the orthopedic surgeon to understand the underlying mechanisms and extent of severity to determine the best approach to management. Methodology: PubMed database was used for article selection, papers on were obtained and reviewed. PubMed database was used for article selection, and the following keys terms: avascular necrosis, femoral head necrosis, ischemic necrosis management. Review: Patients with avascular necrosis present with joint pain of varying degrees. This pain is often associated with an underlying bone framework collapse. Peri-operative classification systems such as Ficat-Arlet criteria are used for staging femoral head necrosis, and proves useful in imaging and operative approach to treatment. Conclusion: The orthopedic surgeon should rely on his/her clinical judgment on per case basis, combining this with high-resolution imaging of radiographs and magnetic resonance. Staging is helpful in determining the best approaches to management.

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Avascular Necrosis of the Femoral Head

Cited by 20 publications

References 9 publications

Cryogenic 3D Printing of ß-TCP/PLGA Composite Scaffolds Incorporated With BpV (Pic) for Treating Early Avascular Necrosis of Femoral Head

Cryogenic 3D Printing of ß-TCP/PLGA Composite Scaffolds Incorporated With BpV (Pic) for Treating Early Avascular Necrosis of Femoral Head

Effect of ligating dogs’ arteries and veins on femoral heads

An overview of the diagnosis and management of Avascular Necrosis

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