Core decompression of the femoral head. Literature review

Panin, Mikhail A.; Александрович, Панин Михаил; Zagorodniy, N. V; Васильевич, Загородний Николай; Абакиров, М Д; Джумабекович, Абакиров Медетбек; Boyko, Andrey V.; Boiko, Andrey V.; Ananyin, D. A.; Алексеевич, Ананьин Данила

doi:10.17816/vto59746

Cited by 5 publications

(1 citation statement)

References 41 publications

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“…Однако многие специалисты отмечают, что хирургическое лечение имеет некоторые преимущества перед консервативным [6]. Следует учитывать, что декомпрессия очага некроза в сочетании с различными клеточными технологиями считается оптимальным методом лечения при I или II стадии заболевания по классификации ARCO (Association Research Circulation Osseous) и неэффективным -при лечении III и IV стадии [7,8].…”

Section: обоснованиеunclassified

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Panin

Zagorodniy

Boiko

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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BACKGROUND: Nowadays total hip arthroplasty (THA) is the method of choice for the treatment of late stages osteonecrosis of the femoral head (OFH) and osteoarthritis (OA) of the hip joint. OBJECTIVE: To evaluate the efficacy and complication pattern of THA in late stages of OFH and OA. MATERIALS AND METHODS: The study included 74 patients who underwent primary THA for OA stages IIIIV (Kellgren and Lawrence classification) and for OFH stages IIIIV (ARCO classification). Group 1 included 34 patients with OFH stages IIIIV, and group 2 40 patients with OA stages IIIIV. The groups were comparable by gender and age. All patients underwent implantation of endoprosthesis components using press-fit fixation with a metalpolyethylene articulation. Treatment results were assessed with regard to the incidence of complications and functional results at 3, 6 months, 1 and 3 years after THA. RESULTS: In our study, the survival rate of components after THA within 3 years after implantation was 100%. No cases of periprosthetic fracture, periprosthetic infection, and aseptic instability of endoprosthesis components were observed in both groups. The surface inflammation of the postoperative wound was detected in 1 (2.9%) patient in the OFH group and in 1 (2.5%) patient in OA group. Dislocation of the endoprosthesis occurred in 1 patient with OFH; there were no such findings in the OA group. The frequency of peri-implant osteolysis was twice lower (2.5%) in patients with OA compared to OFH group (5.8%). There were no statistically significant differences in the functional results dynamics before and after surgery between the groups (Harris score). The average Harris scale score in patients with OFH was 63 and reached 94 after 3 years; in OA group 58 and 94, respectively. CONCLUSION: THA is an alternative method in the treatment of severe hip arthroplasty. Endoprosthetics using a cementless endoprosthesis with a metalpolyethylene articulation demonstrated high efficacy as well as a low number of complications among patients with OFH and OA. We found no significant difference in THA results in terms of survival, postoperative complications, and functional outcome in patients with OFH and OA. Longer postoperative follow-up is advisable, which may allow us to establish some differences in treatment outcomes.

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Section: обоснованиеunclassified

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Panin

Zagorodniy

Boiko

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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Boosting mRNA‐Engineered Monocytes via Prodrug‐Like Microspheres for Bone Microenvironment Multi‐Phase Remodeling

Wu,

Zhu,

Chen

et al. 2024

Adv Healthcare Materials

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Monocytes, as progenitors of macrophages and osteoclasts, play critical roles in various stages of bone repair, necessitating phase‐specific regulatory mechanisms. Here, icariin (ICA) prodrug‐like microspheres (ICA@GM) are developed, as lipid nanoparticle (LNP) transfection boosters, to construct mRNA‐engineered monocytes for remodeling the bone microenvironment across multiple stages, including the acute inflammatory and repair phases. Initially, ICA@GM is prepared from ICA‐conjugated gelatin methacryloyl via a microfluidics system. Then, monocyte‐targeting IL‐4 mRNA‐LNPs are then prepared and integrated into injectable microspheres (mRNA‐ICA@GM) via electrostatic and hydrogen bond interactions. After bone‐defect injection, LNPs are controlled released from mRNA‐ICA@GM within 3 days, rapidly transfecting monocytes for monocyte IL‐4 mRNA‐engineering, which effectively suppressed acute inflammatory responses via polarization programming and paracrine signaling. Afterwards, ICA is sustainably released as well via cleavable boronate esters across multiple stages, cooperatively boosting the mRNA‐engineered monocytes to inhibit coenocytic fusion and osteoclastic function. Both in vitro and in vivo data indicated that mRNA‐ICA@GM can not only reverse the inflammatory environment but also suppress monocyte‐derived osteoclast formation to accelerate bone repair. In summary, mRNA‐engineered monocytes and ICA prodrug‐like microspheres are combined to achieve long‐lasting multi‐stage bone microenvironment regulation, offering a promising repair strategy.

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Comparative Assessment of Surgical Treatment Results of Patients with Early-Stage Avascular Necrosis of the Femoral Head

Kotelnikov,

Kudashev,

Zuev-Ratnikov

et al. 2024

Traumatology and Orthopedics of Russia

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Objective. To conduct a comparative evaluation of the results of surgical treatment of patients with early stage osteonecrosis of the femoral head using different methods of core decompression and autologous bone grafting of the femoral head. Material and methods. A comparative analysis of the results of treatment of patients with early stages of ONFH was carried out. The patients were divided according to the method of treatment into two groups: control and main. In the control group (n=19), surgical treatment was performed using open decompression and autologous bone grafting of the femoral head using the Rosenwasser M.R. technique "light bulb". The main group (n=17) included patients whose surgical treatment was performed using the developed method of combined impaction autoplasty of the femoral head (RF patent for invention No. 2583577 dated April 13, 2016). Clinical and functional evolution of treatment results was performed using the Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Evaluation was performed preoperatively and at 3, 6, and 12 months postoperatively. Results. The comparative analysis showed a significant difference in clinical and functional results after surgical treatment in patients of the control and main groups: patients of the main group demonstrated the best results at all periods of observation, however, their most pronounced difference was noted at a follow-up period of 6 months after surgery, with further preservation of this trend up to 12 months after surgery. Conclusion. A comparative evaluation of the effectiveness of open core decompression with bone autoplasty of the femoral head defect using the “light bulb” method and closed intralesional resection of the necrosis focus with combined impaction plastic of the femoral head revealed that minimal trauma to the para- and intra-articular tissues when accessing the area of the pathological focus and carrying out the main stages of the operation allows you to achieve the best clinical and functional results and create the most optimal conditions for remodeling processes in the osteoplasty area.

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Core decompression of the femoral head. Literature review

Cited by 5 publications

References 41 publications

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Boosting mRNA‐Engineered Monocytes via Prodrug‐Like Microspheres for Bone Microenvironment Multi‐Phase Remodeling

Comparative Assessment of Surgical Treatment Results of Patients with Early-Stage Avascular Necrosis of the Femoral Head

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