Standing Is a Causative Factor in Osteonecrosis of the Femoral Head in Growing Rats

Mihara, Keiji; Hirano, Tôru

doi:10.1097/01241398-199809000-00022

Cited by 32 publications

(11 citation statements)

References 9 publications

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“…Ueo et al [35] discovered that necrotic change might even also appear in the area of good blood supply, which arouses the possible significant role of biomechanics that play in pathogenesis of ONFH. Mihara et al [36] conducted animal research that forced standing rats to create strong stress to their spine cords; ONFH were found in those rats. The above studies revealed that only when the pathogenesis of ONFH is combined with dynamic function of the hip, namely biomechanics, can the onset of ONFH really be explained.…”

Section: Discussionmentioning

confidence: 99%

“…According to research concerning the biomechanics of the hip [35,36], the two key principles of hip-preserving surgery for the treatment of ONFH are promoting repair of the necrotic area and protecting the femoral head from collapsing. The main predictive risk factors of the incidence of collapse depend on the range and area of necrosis [4,11,36,37]. Our research has shown that the more normal shape the femoral head retains, the more hip function is kept.…”

Section: Discussionmentioning

confidence: 99%

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Vascularised greater trochanter bone graft, combined free iliac flap and impaction bone grafting for osteonecrosis of the femoral head

Zeng

He²,

Feng³

et al. 2013

International Orthopaedics (SICOT)

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Purpose To investigate the curative efficacy of osteonecrosis of the femoral head (ONFH) in a hip-preserving operative approach, by grafting a vascularized greater trochanter flap combined with a free iliac flap, in an attempt to seek an innovative approach for patients who suffered middle to late stage ONFH without total hip arthroplasty (THA) surgery. Method Our research included a total of 60 patients (66 hips) who accepted hip-preserving surgery by grafting a vascularized greater trochanter flap combined with a free iliac flap which was tightly filled by hammering because of ONFH (most were Association Research Circulation Osseous (ARCO) stage III patients) from January, 2006 to December, 2010. A Harris Hip Score was obtained during follow-ups, evaluating the clinical efficacy, X-rays were taken regularly for image assessing, and the SF-36 scale was used for estimating quality of life. Terminal observation time was considered when patients had symptom-dependant indications for performing another hip-preserving surgery or THA surgery. Results Fifty-eight patients (64 hips) were eventually contacted by telephone for an out-patient clinic return visit, with a mean follow-up time of 35.8 months (varied from 12 months to 60 months), but two patients lost contact for various reasons. The demographic data were as follows: there were 16 ARCO IIIA cases, 22 ARCO IIIB cases, and 26 ARCO IIIC cases, respectively. Postoperative X-rays revealed a well-repaired necrotic area of the femoral head and improvement of femoral-acetabulum coverage. The last follow-up mean Harris Hip Score was 86.56±7.38 (excellent results reached 87.50 %), which were greatly improved compared to 50.95±6.86 pre-operatively. Also the postoperative mean scores of all dimensions of the SF-36 scale were improved to some extent. Additionally the physical component summary (PSC) scores were enhanced from 42± 13 pre-operatively to 78±11, while the postoperative mental component summary (MCS) scores (76±11) largely increased in contrast to pre-operative scores (51±10), with both target indices having statistical significance (p=0.005, p=0.01), signifying hugely improvement of the quality of life of the patients. A correlation was found between Harris Hip Score and all dimensions of SF-36 scale (r=0.32-0.72), especially closely correlated with physical functioning (PF), role-physical (RP) and bodily pain (BP) in PCS aspect (r= 0.72, p < 0.01; r = 0.58, p < 0.01; r = 0.65, p < 0.01, respectively). Conclusion There is definite curative efficacy for the treatment of ONFH with an hip-preserving operative approach by grafting a vascularized greater trochanter flap combined with a free iliac flap which was tightly filled by hammering. This kind of operative approach reconstructs the biological stability of femoral head, which promotes repair of necrotic areas and indirectly preserves the femoral head of patients and a majority of hip function. It possesses vast clinical as well as practical significance, because the long-term efficacy can satisfy fundam...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vascularised greater trochanter bone graft, combined free iliac flap and impaction bone grafting for osteonecrosis of the femoral head

Zeng

He²,

Feng³

et al. 2013

International Orthopaedics (SICOT)

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“…Hirano et al [45] suggested that ON in the femoral head of spontaneously hypersensitive male rats was attributed to abnormality of the cartilage in the epiphysis and metaphyseal growth plate and subsequent enchondral ossification. Mihara et al [46] found when these rats were placed in cages in which they had to stand for eating as they used to be. There was a significantly higher ON incidence of 40% when the rats were forced to stand.…”

Section: Spontaneous Onfhmentioning

confidence: 99%

Experimental animal models of osteonecrosis

et al. 2011

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Osteonecrosis (ON) or avascular necrosis (AVN) is a common bone metabolic disorder, mostly affecting femoral head. Although many biological, biophysical, and surgical methods have been tested to preserve the femoral head with ON, none has been proven fully satisfactory. It lacks consensus on an optimal approach for treatment. This is due, at least in part, to the lack of ability to systematically compare treatment efficacy using an ideal animal model that mimics full-range osteonecrosis of femoral head (ONFH) in humans with high incidence of joint collapse accompanied by reparative reaction adjacent to the necrotic bone in a reproducible and accessible way. A number of preclinical animal ON models have been established for testing potential efficacy of various modalities developed for prevention and treatment of ON before introduction into clinics for potential applications. This paper describes a number of different methods for creating animal experimental ON models. Advantages and disadvantages of such models are also discussed as reference for future research in battle against this important medical condition.

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“…And the resulting insu cient blood supply to the femoral head and impaired venous return can, in turn, affect the repair of ONFH. Similarly, some studies demonstrate that less acetabular coverage can increase intracapsular pressure, and excessive weight bearing suffered by the hip joint can contribute to the development of ONFH [23][24][25][26]. Junfeng Zeng et al [27] nd that less acetabular coverage may be associated with the development of ONFH in East Asian population, which is also a factor affecting the repair of ONFH.…”

Section: Discussionmentioning

confidence: 99%

Ratio of the Medial Hip Joint Space as a Predictor for Collapse of the Femoral Head in Non-traumatic Osteonecrosis: A Retrospective Study and Finite Element Analysis

Lin

Yang

et al. 2020

Preprint

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Background: There has been no indicators that can effectively predict femoral head collapse in ONFH so far. The aim of this study is to retrospectively analyze the first-visit medial space ratio of the hip joint to evaluate its efficacy in predicting ONFH-induced collapse and impacts on the mechanical environment of necrotic femoral head.Methods: In this retrospective analysis for traditional Chinese medicine (TCM), non-traumatic osteonecrosis of femoral head (NONFH) patients from January 2010 to December 2016 were selected. The medial space ratio at their first visit and and collapse of the femoral head during the follow-up were recorded. Patients were divided into group A, B, C, D, and E according to the grading of the medial space ratio at the first visit. A total of 14 hip joint models with distinct medial space ratios were established. The maximum stress intensities of the cartilage, cortical bone and the necrotic area (N-unit area) of the femoral head in the models were quantitated using a finite element analysis.Results: One hundred twenty-eight patients (142 hips) were included in this study. The average follow-up time was 5.4±1.5 years.The Kaplan-Meier survival analysis showed that survival rates of the first-visit medial space ratios in group C and D were significantly higher (exceeding 45.76%) than that in group E (22.73%). There was no significant difference in the survival rates between group C and D (P > 0.05). The finite element analysis showed that in either the necrosis or non-necrosis group, the maximum stress in cartilage, cortical bone and the N-unit area of the femoral head increased with the medial space ratio decreasing. Conclusion: The medial space ratio shows clinical implications of predicting the collapse of NONFH except for assessing the relationship between the femoral head and the acetabulum. The stress concentrations of cartilage, cortical bone, and the necrotic area of the femoral head are enhanced with the medial space radio decreasing. Once the medial space ratio falls below 4 and continues to decline, the risk of necrotic collapse will become higher.

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Standing Is a Causative Factor in Osteonecrosis of the Femoral Head in Growing Rats

Cited by 32 publications

References 9 publications

Vascularised greater trochanter bone graft, combined free iliac flap and impaction bone grafting for osteonecrosis of the femoral head

Vascularised greater trochanter bone graft, combined free iliac flap and impaction bone grafting for osteonecrosis of the femoral head

Experimental animal models of osteonecrosis

Ratio of the Medial Hip Joint Space as a Predictor for Collapse of the Femoral Head in Non-traumatic Osteonecrosis: A Retrospective Study and Finite Element Analysis

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