Study on the outcome of patients with aseptic femoral head necrosis treated with percutaneous multiple small-diameter drilling core decompression: a retrospective cohort study based on magnetic resonance imaging and equivalent sphere model analysis

Tan, Yang; He, Hangyuan; Wan, Zhongmin; Qin, Jun; Wen, Yinxian; Pan, Zhengqi; Wang, Hua; Chen, Liaobin

doi:10.1186/s13018-020-01786-4

Cited by 15 publications

(10 citation statements)

References 37 publications

(45 reference statements)

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“…It has also been noted that if patients with ANFH are not treated promptly and effectively as required, FHC will occur in approximately 70% of patients within 1 to 4 years as the disease progresses. 26,27 The results of this study showed that hormoneinduced femoral osteonecrosis accounted for a high proportion in the etiology of postoperative FHC in patients with Ficat I, II, and III stages of ANFH, and the range of necrosis was large. High-energy damage was the common damage mechanism, and the preoperative waiting time was long.…”

Section: Discussionmentioning

confidence: 71%

Analysis of Factors Influencing Postoperative Femoral Head Collapse in Patients With Ficat I, II, and III Stages of Aseptic Necrosis of the Femoral Head

Zhang

Cao

et al. 2022

J Am Acad Orthop Surg

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Objective: To investigate the factors influencing postoperative femoral head collapse (FHC) in patients with Ficat I, II, and III stages of aseptic necrosis of the femoral head (ANFH). Methods: Retrospective analysis of 178 patients with ANFH admitted to our hospital from October 2018 to October 2021 was studied, and patients were categorized into the FHC group and no FHC group according to whether FHC occurred after surgery. The influencing factors causing postoperative FHC were analyzed by univariate and multifactor logistic regression. Results: In the collapsed group, there were statistically significant differences in etiology, extent of necrosis, mechanism of injury, preoperative waiting time, Japanese Femoral Necrosis Research Society staging, distance from the tip of the tantalum rod to the center of necrosis, and Harris score after treatment (P , 0.05). The etiology, extent of necrosis, mechanism of injury, preoperative waiting time, Japanese Femoral Osteonecrosis Research Society classification, distance between the tantalum rod tip and the center of necrosis, and Harris score after treatment were set as independent variables, and postoperative FHC in patients with Ficat I, II, and III stages of ANFH was used as the dependent variable in the univariate logistic regression analysis. Discussion: Hormonal osteonecrosis of the femur, extent of necrosis, type C1 and type C2 in the Japanese Society for the Study of Femoral Osteonecrosis staging, and distance of the tip of the tantalum rod from the center of necrosis are risk factors for postoperative FHC in patients with Ficat I, II, and III stages of ANFH. Femoral head (FH) necrosis is a frequent and hard-to-treat orthopaedic disease among young and elderly. [1][2][3] It is mostly caused by poorly repositioned femoral neck fractures and bone tissue self-lesions, and

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Section: Discussionmentioning

confidence: 71%

Analysis of Factors Influencing Postoperative Femoral Head Collapse in Patients With Ficat I, II, and III Stages of Aseptic Necrosis of the Femoral Head

Zhang

Cao

et al. 2022

J Am Acad Orthop Surg

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“…The ideal state should be treated before the collapse of the femoral head, and early treatment must require an early diagnosis, otherwise SONFH patients would lose the optimal treatment opportunity, resulting in a poor prognosis. Current magnetic resonance imaging (MRI) was the gold standard of early SONFH, and compared to X-ray ray and CT scan technology, MRI could be diagnosed several weeks after patient onset [ 32 ]. However, with the understanding of other diseases of the hip joint, such as transient osteoporosis of hip, or bone marrow edema syndrome (BMES), bone cyst of the femoral head, subchondral incomplete fracture and rapid progressive osteoarthritis, SONFH was frequently confused by the above diseases in MRI [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

IRF8 and its related molecules as potential diagnostic biomarkers or therapeutic candidates and immune cell infiltration characteristics in steroid-induced osteonecrosis of the femoral head

Liang

Liu

et al. 2023

J Orthop Surg Res

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Purpose Steroid-induced osteonecrosis of the femoral head (SONFH) was a refractory orthopedic hip joint disease in the young and middle-aged people, but the pathogenesis of SONFH remained unclear. We aimed to identify the potential genes and screen potential therapeutic compounds for SONFH. Methods The microarray was obtained for blood tissue from the GEO database, and then it identifies differentially expressed genes (DEGs). The DEGs were analyzed to obtain the differences in immune cell infiltration. The gene functional enrichment analysis of SONFH was analyzed. The PPI of DEGs was identified through the STRING database, and the cluster modules and hub genes were ascertained using MCODE and CytoHubba, and the ROC curve of hub genes was analyzed, and the tissues distribution of hub genes was understood by the HPA, Bgee and BioGPS databases. The hub genes and target miRNAs and corresponding upstream lncRNAs were predicted by TargetScan, miRDB and ENCORI database. Subsequently, we used CMap, DGIdb and L1000FWD databases to identify several potential therapeutic molecular compounds for SONFH. Finally, the AutoDockTools Vina, PyMOL and Discovery Studio were employed for molecular docking analyses between compounds and hub genes. Results The microarray dataset GSE123568 was obtained related to SONFH. There were 372 DEGs including 197 upregulated genes and 175 downregulated genes by adjusted P value < 0.01 and |log2FC|> 1. Several significant GSEA enrichment analysis and biological processes and KEGG pathway associated with SONFH were identified, which were significantly related to cytoskeleton organization, nucleobase-containing compound catabolic process, NOD-like receptor signaling pathway, MAPK signaling pathway, FoxO signaling pathway, neutrophil-mediated immunity, neutrophil degranulation and neutrophil activation involved in immune response. Activated T cells CD4 memory, B cells naïve, B cells memory, T cells CD8 and T cells gamma delta might be involved in the occurrence and development of SONFH. Three cluster modules were identified in the PPI network, and eleven hub genes including FPR2, LILRB2, MNDA, CCR1, IRF8, TYROBP, TLR1, HCK, TLR8, TLR2 and CCR2 were identified by Cytohubba, which were differed in bone marrow, adipose tissue and blood, and which had good diagnostic performance in SONFH. We identified IRF8 and 10 target miRNAs that was utilized including Targetsan, miRDB and ENCORI databases and 8 corresponding upstream lncRNAs that was revealed by ENCORI database. IRF8 was detected with consistent expression by qRT-PCR. Based on the CMap, DGIdb and L1000FWD databases, the 11 small molecular compounds that were most strongly therapeutic correlated with SONFH were estradiol, genistein, domperidone, lovastatin, myricetin, fenbufen, rosiglitazone, sirolimus, phenformin, vorinostat and vinblastine. All of 11 small molecules had good binding affinity with the IRF8 in molecular docking. Conclusion The occurrence of SONFH was associated with a “multi-target” and “multi-pathway” pattern, especially related to immunity, and IRF8 and its noncoding RNA were closely related to the development of SONFH. The CMap, DGIdb and L1000FWD databases could be effectively used in a systematic manner to predict potential drugs for the prevention and treatment of SONFH. However, additional clinical and experimental research is warranted.

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“…In its progression, FHN leads to the collapse of the femoral head in a large number of patients, with 67% developing collapse even without the manifestation of clinical symptoms [ 12 , 23 ]. Accurate disease staging is thus imperative for FHN to dictate the right course of treatment, particularly in younger patients who may be able to avoid total hip arthroplasty and preserve the native joint [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

A Deep Learning Method for Quantification of Femoral Head Necrosis Based on Routine Hip MRI for Improved Surgical Decision Making

Ruckli

Nanavati

Meier

et al. 2023

JPM

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(1) Background: To evaluate the performance of a deep learning model to automatically segment femoral head necrosis (FHN) based on a standard 2D MRI sequence compared to manual segmentations for 3D quantification of FHN. (2) Methods: Twenty-six patients (thirty hips) with avascular necrosis underwent preoperative MR arthrography including a coronal 2D PD-w sequence and a 3D T1 VIBE sequence. Manual ground truth segmentations of the necrotic and unaffected bone were then performed by an expert reader to train a self-configuring nnU-Net model . Testing of the network performance was performed using a 5-fold cross-validation and Dice coefficients were calculated. In addition, performance across the three segmentations were compared using six parameters: volume of necrosis, volume of unaffected bone, percent of necrotic bone volume, surface of necrotic bone, unaffected femoral head surface, and percent of necrotic femoral head surface area. (3) Results: Comparison between the manual 3D and manual 2D segmentations as well as 2D with the automatic model yielded significant, strong correlations (Rp > 0.9) across all six parameters of necrosis. Dice coefficients between manual- and automated 2D segmentations of necrotic- and unaffected bone were 75 ± 15% and 91 ± 5%, respectively. None of the six parameters of FHN differed between the manual and automated 2D segmentations and showed strong correlations (Rp > 0.9). Necrotic volume and surface area showed significant differences (all p < 0.05) between early and advanced ARCO grading as opposed to the modified Kerboul angle, which was comparable between both groups (p > 0.05). (4) Conclusions: Our deep learning model to automatically segment femoral necrosis based on a routine hip MRI was highly accurate. Coupled with improved quantification for volume and surface area, as opposed to 2D angles, staging and course of treatment can become better tailored to patients with varying degrees of AVN.

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Study on the outcome of patients with aseptic femoral head necrosis treated with percutaneous multiple small-diameter drilling core decompression: a retrospective cohort study based on magnetic resonance imaging and equivalent sphere model analysis

Cited by 15 publications

References 37 publications

Analysis of Factors Influencing Postoperative Femoral Head Collapse in Patients With Ficat I, II, and III Stages of Aseptic Necrosis of the Femoral Head

Analysis of Factors Influencing Postoperative Femoral Head Collapse in Patients With Ficat I, II, and III Stages of Aseptic Necrosis of the Femoral Head

IRF8 and its related molecules as potential diagnostic biomarkers or therapeutic candidates and immune cell infiltration characteristics in steroid-induced osteonecrosis of the femoral head

A Deep Learning Method for Quantification of Femoral Head Necrosis Based on Routine Hip MRI for Improved Surgical Decision Making

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