Hip osteonecroses treated with calcium sulfate-calcium phosphate bone graft substitute have different results according to the cause of osteonecrosis: alcohol abuse or corticosteroid-induced

Sionek, Andrzej; Czwojdziński, Adam; Kowalczewski, Jacek; Okoń, Tomasz; Marczak, Dariusz; Sibiński, Marcin; Złotorowicz, Marcin; Czubak, Jarosław

doi:10.1007/s00264-018-3892-0

Cited by 27 publications

(31 citation statements)

References 27 publications

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“…It is true that the results of core decompression alone are confusing: considering that small lesions do not progress or progress slowly without any intervention and the fact that core decompression shows better outcomes in hips with small early lesions, core decompression alone might be considered sometimes as a treatment that is not so efficient; however, it provides symptomatic relief, and it appears to prevent collapse in early stages. Some authors have associated core decompression to bone substitute or tantalum implants [26][27][28][29].…”

Section: Core Decompression and Mechanical Adjuvant To Prevent Collapsementioning

confidence: 99%

Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Hernigou¹,

Daltro

Hernigou

2018

International Orthopaedics (SICOT)

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Section: Core Decompression and Mechanical Adjuvant To Prevent Collapsementioning

confidence: 99%

Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Hernigou¹,

Daltro

Hernigou

2018

International Orthopaedics (SICOT)

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“…Broken cartilage and necrotic subchondral bone was no longer replanted. Compared with previous studies [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] , this report includes superior results. The rate of clinical success (good or excellent outcome) was 92.5% for 67 hips.…”

Section: Discussionmentioning

confidence: 82%

“…The rationale for head-preserving procedures is the desire to provide sufficient and long-lasting support to necrotic subchondral bone and cartilage [38] , in order to prevent collapse and subsequent osteoarthrosis of the joint. A tantalum rod was used to provide direct mechanical support [16] ; a bone graft was aimed to replace dead bone with viable bone [12][13][14] . Various types of stem cells and/or biofactors were used to facilitate bone formation and remodeling, alone or in combination with other methods [15,19] .…”

Section: Discussionmentioning

confidence: 99%

“…The treatment procedures performed most commonly include core decompression, osteotomy, non-vascularized or vascularized bone graft, enriched bone substitutes, transplantation of a tantalum rod, and autologous bone marrow stem cell implantation. All of these procedures aim to promote bone regeneration and/or provide mechanical support [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] . However, none of these treatment modalities have been found to be universally successful.…”

Section: Introductionmentioning

confidence: 99%

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Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Cheng

zhao

et al. 2020

Preprint

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Background The aim of the present study was to investigate clinical and radiological outcomes of autologous tricortical iliac graft through a window created at the femoral head, without suturing the opened articular cartilage to treat osteonecrosis of the femoral head (ONFH), called modified trapdoor procedures.Methods A total of 59 consecutive patients (67 hips; 36 males and 23 females) with ONFH were included in this study, which was conducted during the period from April 2009 to March 2012. Patient age ranged from 27 to 46 years old, with mean age of 36.3 years. Harris hip scores (HHS) were used to evaluate hip function pre- and postoperatively. Anteroposterior and frog-position X-rays and magnetic resonance imaging (MRI) were conducted to evaluate lesion location, size, and ARCO stage. Clinical failure was defined as score < 80 points or treatment by total hip arthroplasty(THA). Radiographic failure was defined as a > 3 mm of collapse in the hip. This group was retrospectively matched according to the ARCO stage, extent, location, etiology of the lesion, average age, gender, and preoperative Harris hip score to a group of 59 patients (67 hips) who underwent the“light bulb”approach during March 2007 to April 2009. Results Mean follow-up was 91.2 ± 13.6 months (range, 75–115 months). Mean HHS was 91.3 ± 4.5, compared with 83.1± 4.5 in the “light bulb” cohort at the 6 years follow-up examination (P < 0.001). At the 6 years follow-up, for modified trapdoor procedures, five hips (8.5%) were classified as clinical failure, and 3 hips underwent total hip arthroplasty; Seven hips were classified as (10.4%) radiographic failure.The clinical and radiographic failure of the hips treated with the modified trapdoor procedure was significantly lower than that of the hips treated with the “light bulb” procedure (p < 0.05). Survival of the joint was not significantly related to the location of the femoral head lesion between two groups, but there was better clinical and radiographic results in modified trapdoor procedures with Size-C and the ARCO stage III.Conclusion The study demonstrated superior medterm clinical results in ONFH with the use of autologous tricortical iliac block graft through a femoral head window, without suturing the opened articular cartilage. The results of this femoral head-preserving procedure in patients with postcollapse osteonecrosis and large lesion are superior to those of the “light bulb” procedure treatment.

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“…It remains difficult for the orthopedic surgeon to feel justified a THA even with new implants [15,16] in a young patient simply for hip pain without femoral head collapse. Several conservative approaches [17,18] have been proposed for osteonecrosis treatment including weight restriction and observation, core decompression, various osteotomies, and bone grafting (structural or nonstructural and fibula vascularized or non-vascularized). However, these techniques have high failures reports for some of them, and others change the morphology of the hip which may be non-esthetic in a young woman [19].…”

Section: Discussionmentioning

confidence: 99%

Unusual indication of Cell therapy for hip osteonecrosis after pregnancy

Hernigou¹,

Rigoulot²,

Auregan³

et al. 2018

SICOT-J

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Purpose: Osteonecrosis is a rare event during or after pregnancy. Due to the low number of cases, there is no report of long-term results after conservative surgery in this population.Method: From 1992 to 2010, 145 consecutive female patients with unilateral symptomatic (94 stage I and 51 stage II) left hip osteonecrosis (ON) related to pregnancy were treated between 4 and 16 months after delivery with percutaneous mesenchymal stem cell (MSC) injection obtained from bone marrow concentration. The average total number of MSCs (counted as number of colonies forming units-fibroblast) injected in the hip was 185 000 ± 65 000 cells (range 95 000–240 000 cells).Results: At the most recent follow-up (average 15 years after hip surgery, range 8–25 years), among the 145 hips included in the study, 4 hips (2.7%) had collapsed and were treated with total hip arthroplasty (THA). Thirty-two of the 94 stage I had progressed to stage II; and 4 of the 51 stage II had progressed to stage III and collapse. The other 141 hips (97.3%) were without collapse and pain free. On MRI, as percentage of the volume of the femoral head, the osteonecrosis had decreased from 34.5% pre-operatively to 6% at the most recent follow-up. For women who had other children after treatment, a subsequent pregnancy was not associated with osteonecrosis.Conclusion: Patients with hip osteonecrosis following pregnancy had a low conversion rate to THA when treated early with cell therapy.

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Hip osteonecroses treated with calcium sulfate-calcium phosphate bone graft substitute have different results according to the cause of osteonecrosis: alcohol abuse or corticosteroid-induced

Cited by 27 publications

References 27 publications

Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage to treat osteonecrosis of the femoral head: A Prospective Cohort Study With Historical Controls

Unusual indication of Cell therapy for hip osteonecrosis after pregnancy

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