Iloprost for the treatment of bone marrow edema in the hindfoot

Aigner, N; Meizer, R; Stolz, G; Petje, G.; Krasny, Christian; Landsiedl, F; Steinboeck, G.

doi:10.1016/s1083-7515(03)00145-1

Cited by 33 publications

(32 citation statements)

References 32 publications

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“…The increase capillary permeability results in a diffuse abnormally increased interstitial water content of the marrow indicating hypervascularity and repair activity [7]. Moreover, there is evidence of a successful treatment of BMES with iloprost [8,9], which has the effect to dilate arterioles and venules, reducing the permeability of capillaries. A possible undisclosed etiological factor leading to an abnormal vasomotor response may be represented by microtrauma that leads to trabecular fractures.…”

Section: Discussionmentioning

confidence: 99%

Transient osteoporosis of the hip: successful treatment with teriparatide

et al. 2010

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A 62-year-old man presented with a 2-month history of increasing pain in the left hip. Magnetic resonance imaging (MRI) showed bone marrow edema (BME) of the left femur, dual energy X-ray absorptiometry (DXA) showed osteopenia at the same level, whereas pelvis X-rays failed to show any objective findings. After ruling out other possible causes of BME such as aseptic osteonecrosis, infectious arthritis, primary or metastatic malignancy, tuberculosis, osteomyelitis, rheumatoid arthritis, and seronegative spondyloarthropathies, a diagnosis of transient osteoporosis of the hip (TOH) was made, and treatment with teriparatide at a daily dose of 20 μg was started and continued for 4 weeks. Disappearance of the symptoms and normalization of MRI were obtained.

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Section: Discussionmentioning

confidence: 99%

Transient osteoporosis of the hip: successful treatment with teriparatide

et al. 2010

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“…The use of iloprost for the treatment of painful BMO (compartment syndrome of the bone) and AVN represents an off-label-use at present. Due to promising results of other groups [8][9][10][11][12][13] and to our own positive experience [14] we started a prospective study on the curative potential and analgesic efficiency of iloprost in 2002 as previously reported [1]. our institution.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of iloprost treatment for osseous malperfusion

Jäger

Zilkens

Bittersohl

et al. 2010

International Orthopaedics (SICOT)

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Insufficient osseous blood supply results in bone marrow oedema (BMO) and/or avascular necrosis (AVN). One treatment option to support osseous perfusion is the application of stable prostacycline analog iloprost. In this clinical study, 95 patients were treated with iloprost for BMO/AVN. One hundred eighty-six bones were affected by BMO/AVN before treatment. Average follow-up was 33.0± 17.6 months. Pain levels could be reduced (e.g. visual analogue scale, 5.0±2.2 points reduced to 1.7±2.2 points) and functional scores improved (Harris hip score, 52±21 points to 79±17 points) in the course of treatment. According to current data, healing of advanced stages of osteonecrosis is not possible. However, the results of this case series confirm previous findings that in early stages of insufficient osseous blood flow iloprost can contribute to the relief of pain and improve joint function.

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“…Recommendations such as protected and limited weight-bearing and use of analgesics can result in complete resolution. Bisphosphonate (alendronate) and iloprost are helpful medications (10,11). Surgical decompression for conservative therapy resistant cases can be a good choice (12).…”

Section: Discussionmentioning

confidence: 99%