Digital subtraction angiography in selection of the vascularized greater trochanter bone grafting for treatment of osteonecrosis of femoral head

Abstract

The aim of this report is to present our experience on the use of the digital subtraction angiography (DSA) in selection of the vascularized greater trochanter bone grafting for the treatment of the osteonecrosis of femoral head (ONFH) in early stages. Between January 2005 and June 2007, DSA was used to evaluate the blood perfusion of the early stages ONFH in 32 patients (45 hips). There were 18 males and 14 females with an average age of 30 years old. Twenty-one hips were in ARCO stage I, and 24 in ARCO stage II. The arterial blood supply insufficiency was found in 22 hips by DSA, and the venous stasis in 23 hips. The hips with artery blood supply insufficiency received the vascularized greater trochanter bone grafting, and the hips with the venous stasis received the core decompression. All of patients were followed-up with an average of 4.8 years (ranging 2.4-6.6 years). The preoperative Harris Hip score (HHS) in the patients with arterial blood supply insufficiency was 48.18 ± 7.81 and the postoperative HHS was 93.27 ± 3.03. The preoperative HHS in the patients with venous stasis was 44.04 ± 6.40, and the postoperative HHS 92.65 ± .93. The postoperative DSA showed an improved perfusion of the femoral head in 44 hips. Our experience showed that DSA would help to select the appropriate procedure for treatment of ONFH in the early stage.

Bilateral comparison of the vascular pattern of the superficial temporal artery based on digital subtraction angiography

“…In the here presented work, we addressed the question whether there is an intra-individual difference of the vascular pattern and the surgically relevant parameters (diameters and lengths) of the STA in the in vivo state using DSAs [25]. In only 10 of the examined 38 cases, the same vascular pattern of the STA was observed on both sides.…”

“…In this work, the most common variations of the branching pattern of the STA as well as surgically relevant inner diameters and lengths of its main branches were assessed. As demonstrated before, the DSA and the multidetector-row CT angiography are established methods for anatomic in vivo examinations [10,25].…”

Early diagnosis and treatment of steroid-induced osteonecrosis of the femoral head

“…The main feeding artery supplying the femoral head is the supporting artery on the femoral neck that originates from the medial femoral artery (or from the inferior gluteal artery). The DSA technique can clearly reveal the blood supply of the circumflex femoral head artery and the artery of the supporting artery after ONFH [13]. The IIa/b stage is the venous stasis period.…”

Th17 i IL-17 osiągają wyższe stężenia w przebiegu martwicy głowy kości udowej i są dodatnio skorelowane z nasileniem bólu

“…We divided the ONFH into four clinical stages mainly by iconography and clinical manifestation according to a previously published grading system [7].…”

“…Chronic pain is the most remarkable symptom that seriously disturbs ONFH patients. Osteonecrosis can be categorised into four stages according to a previously published grading system [7]. The level of pain varies among patients.…”