Osteonecrosis of the Femoral Head After Solid Organ Transplantation

Marston, Scott B.; Gillingham, Kristen J.; Bailey, Robert F.; Cheng, Edward Y.

doi:10.2106/00004623-200212000-00004

Cited by 87 publications

(48 citation statements)

References 25 publications

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“…It is not related to the cumulative dosage of MP and tacrolimus or the early withdrawal of MP. Our findings are consistent with the reports by others, 4,8,[20][21][22][23] suggesting that symptomatic ONFH is rather uncommon in this cohort of liver transplant patients on current immunosuppressive protocols. The underlying mechanism of osteonecrosis in liver transplant recipients is complex, which may be related to corticosteroid use, hypercoagulable state, or hypofibrinolysis.…”

Section: Discussionsupporting

confidence: 93%

“…Marston and associates reported the incidence of ONFH as 20% one year after renal transplant. 4 In other studies, however, the incidence of ONFH was as low as 1.5% to 4.6% in liver, kidney, and heart transplant recepients. [5][6][7][8] In addition, some rare conditions also should be considered, including calcineurin-inhibitor-induced pain syndrome (CIPS).…”

Section: Introductionmentioning

confidence: 84%

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Immunosuppressant-Related Hip Pain After Orthotopic Liver Transplant

He²,

Fu³

et al. 2012

Exp Clin Transplant

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Objectives: Immunosuppressant-related hip pain can greatly affect a patient's mobility and increase the number of total hip arthroplasties. We investigated risk factors and causes of hip pain after orthotopic liver transplant. Materials and Methods:The medical records of 175 adult orthotopic liver transplant patients, who were followed-up for more than 2 years, were retrospectively reviewed. Data collected from the records included primary disease, medications, biochemical results, Child-Turcotte-Pugh score, death, rejection, and complications related to liver transplant. Results: A total of 11 patients (6.3%) complained of hip pain, which was diagnosed as calcineurininhibitor-induced pain syndrome in 4 patients (2.3%), osteonecrosis of the femoral head in 3 patients (1.7%), and osteoporosis in 2 patients (1.1%). The incidence of calcineurin-inhibitorinduced pain syndrome was related to the dosage of tacrolimus (P > .05) but independent of methylprednisolone use. The occurrence of osteonecrosis of the femoral head was independent of the dosage and early withdrawal of methylprednisolone (P > .05). Patients with methylprednisolone withdrawal within 6 months had significantly longer survival than those using methylprednisolone for more than 6 months (50 ± 15 vs 41 ± 18 mo; P = .007). Conclusions: Calcineurin-inhibitor-induced pain syndrome and osteonecrosis of the femoral head are main causes of hip pain in adult orthotopic liver transplant patients. Osteonecrosis of the femoral head was not common, but the incidence of hip pain owing to calcineurin-inhibitor-induced pain syndrome was relatively high in orthotopic liver transplant patients. Early withdrawal of methylprednisolone could benefit the patients' survival.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 84%

Immunosuppressant-Related Hip Pain After Orthotopic Liver Transplant

He²,

Fu³

et al. 2012

Exp Clin Transplant

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“…It has been demonstrated that cumulative intravenous methylprednisolone at doses of >2 g for >3 months significantly increased the risk for ON [16]. The frequent inclusion of corticosteroids in treatment protocols for various medical conditions, such as acute lymphoblastic leukemia (ALL), various lymphomas, and either solid organ or bone marrow transplantation, clearly put these patients at an increased risk for ON [17][18][19][20][21][22][23][24]. In a prospective MRI study, the incidence of ON associated with corticosteroid therapy was significantly higher in systemic lupus erythematosus (SLE) patients than in non-SLE patients (37 versus 21 %, P=0.001) [25•].…”

Section: Corticosteroidsmentioning

confidence: 99%

“…Risk factors for ON were age (adolescents and adults compared to pediatric patients), high daily corticosteroid dosage (>40 mg/day), SLE patient compared to non-SLE patient, and male gender. In solid organ transplantation patients, Marston and Cheng [20] prospectively analyzed 52 patients (103 hips) and reported the prevalence of osteonecrosis of the femoral head as 11 % at 1 year after the transplantation. In patients with acute lymphoblastic leukemia treated with multiple, prolonged courses of corticosteroid, the Children's Cancer Group reported that 111 of 1409 patients had ON with a 3-year life-table estimated incidence of 9.3 % [21].…”

Section: Corticosteroidsmentioning

confidence: 99%

Osteonecrosis of the femoral head: diagnosis and classification systems

Choi

Steinberg

Cheng

2015

Curr Rev Musculoskelet Med

103

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Osteonecrosis of femoral head is a rare but disabling condition that usually results in progressive femoral head collapse and secondary arthritis necessitating total hip arthroplasty if not treated appropriately in early stages. However, early diagnosis is challenging as the onset of disease is insidious and the symptoms and signs are usually minimal and nonspecific until it becomes advanced. Of several diagnostic modalities, magnetic resonance imaging (MRI) is considered the imaging method of choice with the highest sensitivity and specificity, while detection of potential risk factors is very important as well. Many investigators have developed several different classification systems; however, there still is controversy regarding the optimal classification system. Diagnostic methods and the evolution of different classification systems will be reviewed in this paper.

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“…μετά από μεταμόσχευση νεφρού ή άλλων οργάνων) (Fink 1998, Marston 2002, το κάπνισμα, η ακτινοβολία (Cramer 2002), η χημειοθεραπεία (Dawson 2001), η νόσος του Gaucher (Katz 1996, Rodrigue 1999, η θρομβοφιλία (Glueck 2001) καθώς και κάποιοι άλλοι σπανιότεροι παράγοντες (Ries 2002). Η οστεονέκρωση που δεν συσχετίζεται με κάποιο από τους γνωστούς αιτιολογικούς παράγοντες χαρακτηρίζεται ως ιδιοπαθής.…”

Section: αιτιοπαθογένεια -παθοφυσιολογίαunclassified

Υπολογιστικός Προεγχειρητικός Σχεδιασμός Του Μυοσκελετικού Συστήματος

Κουμπογιάννης¹

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Osteonecrosis of the Femoral Head After Solid Organ Transplantation

Cited by 87 publications

References 25 publications

Immunosuppressant-Related Hip Pain After Orthotopic Liver Transplant

Immunosuppressant-Related Hip Pain After Orthotopic Liver Transplant

Osteonecrosis of the femoral head: diagnosis and classification systems

Υπολογιστικός Προεγχειρητικός Σχεδιασμός Του Μυοσκελετικού Συστήματος

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