Core decompression of steroid induced avascular necrosis of the talus

Guest, M. Mason; Binfield, Peter M.; O’Doherty, D. P.

doi:10.1054/foot.1999.0504

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…In particular, talar neck fractures often lead to disruption of the blood supply 1 . Osteonecrosis can also result from nontraumatic causes, including steroid usage 8 , hyperuricemia 9 , pancreatitis 10 , alcoholism 7 , sickle cell disease 7 , dyslipidemia 7 , and “idiopathic” osteonecrosis 7 . Additionally, osteonecrosis can potentially arise from total ankle replacement (TAR) due to the risk of disruption to the extraosseous blood supply of the talus 11 .…”

Section: Resultsmentioning

confidence: 99%

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Clinical Use of Talar Prostheses

2021

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The blood supply to the talus is vulnerable to damage, making the talus susceptible to osteonecrosis, with limited treatment options. » Talar bone replacement has been investigated as a treatment option to preserve ankle function and maintain limb length. » Successful talar bone replacements have been performed for the past .35 years, with variations in design, methods of fixation, materials, and manufacturing techniques.» The designs of talar prostheses range from custom-made partial (talar body) or total prostheses to prefabricated universal (non-custommade) prostheses.» Total talar prostheses have been demonstrated to function better than partial talar prostheses; however, there is a need for long-term studies regarding custom-made total talar prostheses and prefabricated universal talar prostheses in order to determine their long-term effectiveness.Disclosure: A.S.D. was supported by a summer studentship provided by Alberta Innovates Health Solutions. The funding source did not place a role in this investigation. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/ JBJSREV/A701).

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Section: Resultsmentioning

confidence: 99%

“…These treatments can be used when the disease is diagnosed early 13 . Surgical treatments such as core decompression 8 or bone-grafting resulting in revascularization 14 can be used for treatment before talar collapse. For advanced osteonecrosis without talar collapse, TAR can be used 4 .…”

Section: Resultsmentioning

confidence: 99%

Clinical Use of Talar Prostheses

2021

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“…Osteonecrosis of the talus (ONT) may be caused by trauma, usage of prednisone, cytostatica treatment or some systematic immune diseases and so on [1]–[5]. Blockage or disturbance of the blood circulation is thought to be the direct cause of ONT.…”

Section: Introductionmentioning

confidence: 99%

The Treatment Effect of Porous Titanium Alloy Rod on the Early Stage Talar Osteonecrosis of Sheep

Yuan

Wang

et al. 2013

PLoS ONE

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Osteonecrosis of the talus (ONT) may severely affect the function of the ankle joint. Most orthopedists believe that ONT should be treated at an early stage, but a concise and effective surgical treatment is lacking. In this study, porous titanium alloy rods were prepared and implanted into the tali of sheep with early-stage ONT (IM group). The curative effect of the rods was compared to treatment by core decompression (DC group). No significant differences in bone reconstruction were observed between the two groups at 1 month after intervention. After 3 months, the macroscopic view of gross specimens of the IM group showed ordinary contours, but the specimens of the DC group showed obvious partial bone defects and cartilage degeneration. Quantitative analysis of the reconstructed trabeculae by micro-CT and histological study suggested that the curative effect of the IM group was superior to that of the DC group at 3 months after intervention. These favorable short-term results of the implantation of porous titanium alloy rods into the tali of sheep with early-stage ONT may provide insight into an innovative surgical treatment for ONT.

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“…Osteonecrosis of the talus (ONT) is a degenerative skeletal disease accompanied with continuous pain and dysfunction of the ankle, which can seriously compromise the routine work and physical activities of patients. ONT could be easily caused by some traumatic ankle injuries such as fractures and dislocations or some untraumatic diseases including systemic lupus erythematosus, scleroderma, insulin-dependent diabetes mellitus, multiple sclerosis, alcohol abuse, heavy smoking and so on 1 - 5 . Most ONTs have generally experienced a phase of ischemic injury after the disturbance of blood circulation, although the detailed pathophysiological process remained unknown 6 - 8 .…”

Section: Introductionmentioning

confidence: 99%

Development of a Clinically Relevant Animal Model for the Talar Osteonecrosis in Sheep

Yuan¹,

Wang²,

Zhang³

et al. 2012

Int. J. Med. Sci.

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There are a lot of reports and reviews about osteonecrosis of the talus (ONT), yet reports about the animal model of ONT to evaluate proper therapeutic approaches are rarely heard. In our study, a novel animal model was established. Pure ethanol was injected into the cancellous bone of sheep's talus. Macroscopic observation, X-ray, CT and histology were performed at two, four, 12 and 24 weeks postoperatively. It was revealed that the trabeculae of talar head began to change their structure after two weeks postoperatively compared to the normal talus. The ONT was obvious at the end of the fourth week, and their outstanding feature was the damage of trabeculae bone and formation of cavities. CT scans and pathological changes of the subjects all showed characteristics of the early stage of osteonecrosis, also the sections of the specimens confirmed necrosis of tali. By 12 weeks, the phenomenon of necrosis still existed but fibrous tissue proliferated prominently and bone reconstruction appeared in certain area. Most specimens (3/4) got late stage necrosis which presented as synarthrosis in X-ray and mass proliferation of fibrous tissue in histology at the end of 24 weeks. The novel animal model of ONT was successful, and it is inclined to deteriorate without any intervention. The study provides us a new way to evaluate various treatments on ONT in laboratory, which may eventually pave way to clinical applications.

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Core decompression of steroid induced avascular necrosis of the talus

Cited by 3 publications

References 8 publications

Clinical Use of Talar Prostheses

Clinical Use of Talar Prostheses

The Treatment Effect of Porous Titanium Alloy Rod on the Early Stage Talar Osteonecrosis of Sheep

Development of a Clinically Relevant Animal Model for the Talar Osteonecrosis in Sheep

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