Quality of life of patients with osteonecrosis of the femoral head: a multicentre study

Uesugi, Yuko; Sakai, Takashi; Seki, Tomohiro; Hayashi, Shinya; Nakamura, Junichi; Inaba, Yutaka; Takahashi, Daisuke; Sasaki, Kan; Motomura, Goro; Mashima, Naohiko; Kabata, Tamon; Sudo, Akihiro; Jinno, Tetsuya; Ando, Wataru; Nagoya, Satoshi; Yamamoto, Kenjiro; Nakasone, Satoshi; Ito, Hiroshi; Yamamoto, Takuya; Sugano, Nobuhiko

doi:10.1007/s00264-018-3897-8

Cited by 25 publications

(11 citation statements)

References 24 publications

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“…ONFH leads to collapse of the femoral head in 80% of cases, results in osteoarthritis in young patients and affects the patient's quality of life [7,21]. The present study showed that the co-treatment of LPZ with corticosteroids prevents the development of ONFH in experimental animals, as well as in patients with immune disease treated with corticosteroids.…”

Section: Discussionsupporting

confidence: 55%

The proton pump inhibitor, lansoprazole, prevents the development of non-traumatic osteonecrosis of the femoral head: an experimental and prospective clinical trial

Kosukegawa

Okazaki

Yamamoto

et al. 2020

Eur J Orthop Surg Traumatol

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Background An effective prevention strategy for osteonecrosis of the femoral head (ONFH) has yet to be established. We previously reported that the innate immune system via the toll-like receptor (TLR) response induced by corticosteroids leads to the development of ONFH and that repression of IRF7 activity by an inhibitor could interfere with the development of ONFH while maintaining the therapeutic effect of the corticosteroids. Objective In the present study, we hypothesize that lansoprazole has the potential to suppress IRF7 activity and prevent corticosteroid-induced ONFH in rats. Furthermore, we conducted a preliminary clinical trial to prevent corticosteroid-induced ONFH in autoimmune disease patients. Methods Male Wistar rats were randomly divided into four groups. On Day 1, each rat was injected with TLR4 ligand (LPS) or TLR7 ligand (imiquimod), followed by methylprednisolone with or without lansoprazole on Day 2. They were killed at 1 or 14 days after the last injection.We prospectively recruited 30 patients requiring primary high-dose corticosteroid treatment for immune diseases. All patients were administered lansoprazole, starting the night before corticosteroid treatment began. MRI was performed before corticosteroid treatment, and at 4, 12 and 24 weeks afterward. Results In rats, co-treatment of lansoprazole with corticosteroids significantly repressed both IRF7 activity and the development of ONFH. Moreover, in the human patients, the incidence of ONFH was significantly decreased from 53.4 to 13.3%. Conclusions Although the present study is preliminary, the results show that co-treatment of lansoprazole with corticosteroids prevents ONFH development. Lansoprazole may be both safe and effective in preventing osteonecrosis of the femoral head in patients needing corticosteroid treatment.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Discussionsupporting

confidence: 55%

The proton pump inhibitor, lansoprazole, prevents the development of non-traumatic osteonecrosis of the femoral head: an experimental and prospective clinical trial

Kosukegawa

Okazaki

Yamamoto

et al. 2020

Eur J Orthop Surg Traumatol

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“…Bilateral hip osteonecrosis is a condition that affects the quality of life [22,23] in patients with osteonecrosis of the femoral head. Males are affected up to three times more than females.…”

Section: Risk Of Collapse and Quality Of Lifementioning

confidence: 99%

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

Hernigou¹,

Daltro

Hernigou

2018

International Orthopaedics (SICOT)

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“…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]. Our technique demonstrates good results and better results than those observed in other causes of osteonecrosis with the same technique [12,20,21].…”

Section: Discussionmentioning

confidence: 78%

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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Quality of life of patients with osteonecrosis of the femoral head: a multicentre study

Abstract: Collapsed ONFH was associated with low QOL scores. Among patients with non-collapsed lesions, alcohol-associated ONFH, bilateral disease, and male sex were linked to low QOL scores.

Cited by 25 publications

References 24 publications

The proton pump inhibitor, lansoprazole, prevents the development of non-traumatic osteonecrosis of the femoral head: an experimental and prospective clinical trial

The proton pump inhibitor, lansoprazole, prevents the development of non-traumatic osteonecrosis of the femoral head: an experimental and prospective clinical trial

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

Unusual indication of Cell therapy for hip osteonecrosis after pregnancy

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