MRI-controlled analysis of 104 patients with painful bone marrow edema in different joint localizations treated with the prostacyclin analogue iloprost

Meizer, R; Radda, C; Stolz, G; Kotsaris, S; Petje, G.; Krasny, Christian; Wlk, M; Mayerhoefer, Marius E.; Landsiedl, F; Aigner, N

doi:10.1007/s00508-005-0326-y

Cited by 112 publications

(69 citation statements)

References 32 publications

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“…Aigner et al successfully treated patients with BME of the forefoot and the acetabulum in 2001 and 2002 with iloprost [10,12] and first demonstrated a clinical benefit, especially in early stages of the disease. Meanwhile, these findings were reproduced by further studies [1,13,24,25].…”

Section: Discussionmentioning

confidence: 53%

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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Section: Discussionmentioning

confidence: 53%

Efficiency of iloprost treatment for osseous malperfusion

Jäger

Zilkens

Bittersohl

et al. 2010

International Orthopaedics (SICOT)

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“…It is thought that prostaglandin I2 ([PGI2] or synonoma prostacyclin) and its analogs promote bone regeneration on a cellular or systemic level. One prostacyclin derivative, ilioprost, has demonstrated beneWcial eVects on avascular osteonecrosis [71], regional transient osteoporosis [72] and transient osteoporosis [73].…”

Section: Prostaglandin Derivativesmentioning

confidence: 99%

Bone marrow lesions: a universal bone response to injury?

Eriksen

Ringe

2011

Rheumatol Int

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The ever increasing use of magnetic resonance imaging in clinical practice has led to the recognition of a new entity, bone marrow lesions (BMLs). These lesions are characterized by excessive water signals in the marrow space and have emerged as a central component of many different diseases affecting the musculoskeletal system. BMLs have in particular been associated with a wide variety of inflammatory and non-inflammatory rheumatologic conditions and are not only considered significant sources of pain, but also linked to the worsening of patient prognosis in many disease states. In this review, we summarize the current knowledge on BMLs with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease and provide a unifying hypothesis based on the appearance with various imaging technologies. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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“…Excellent results with very fast recovery have been obtained in all cases of isolated bone marrow edema syndrome lacking signs of necrotic areas [35]. Contrary to other therapeutic options, additional intervention such as reduced weight bearing was not required in most cases.…”

Section: Discussionmentioning

confidence: 95%