Pathogenesis and treatment of osteonecrosis of the shoulder

Shoulder hemiarthroplasty for steroid-associated osteonecrosis

“…Other results that have been reported have not separated steroid-induced ON from other diagnostic groups, and these studies usually grouped HHR and TSA together in their outcomes. 7,14,17,21 Hattrup and Cofield,7 looking at the results of replacement for humeral head ON at our institution, noted superior results in steroid-induced ON compared with post-traumatic ON. However, HHR for steroid-induced ON was not isolated in reporting the results.…”

“…Humeral head replacement (HHR) has been advocated for stage III and stage IV disease, when the glenoid cartilage is intact, and total shoulder arthroplasty (TSA) for stage V disease. 7,21 There has been very little reported on HHR for steroidassociated ON. The few studies on ON of the humeral head have not separated steroid-induced ON from other diagnostic groups and have often grouped TSA together with HHR in their outcomes.…”

“…The few studies on ON of the humeral head have not separated steroid-induced ON from other diagnostic groups and have often grouped TSA together with HHR in their outcomes. 3,7,14,15,17,20,21 The purpose of this study is to evaluate the outcome of patients who underwent HHR for steroid-associated ON to determine the results, risk factors for an unsatisfactory result, and rates of revision surgery.…”

Expression of the angiomatrix and angiogenic proteins CYR61, CTGF, and VEGF in osteonecrosis of the femoral head

“…[5][6][7][8][9][10] The precise pathophysiologic mechanism of ON is not known, and several hypotheses have been presented. [11][12][13][14][15][16] The efficiency of the bone repair processes in ON determines whether ON is reversible or irreversible. 17 Angiogenesis as an important part of the bone repair process, and the close connection between blood vessels (endothelial cells) and bone (osteoblasts) was already recognized by Trueta 18 in 1963, who suggested the existence of a vascular stimulating factor active in areas of bone damage.…”

Une luxation bilatérale postérieure des épaules sur ostéonécrose des têtes humérales

“…En effet, l'effet des corticoïdes sur les os et plus particulièrement leur responsabilité dans les ostéonécroses aseptiques est bien démontré dans la littérature [5]. Les ostéonécroses de la tête humérale (caput humeri) sont les secondes plus fréquents après celle de la tête fémorale (caput femoris).…”