Treatment of aseptic necrosis of the femoral head. Clinical guidelines

Торгашин, А Н; Родионова, С. С.; Шумский, А. А.; Макаров, М. А.; Torgashina, A.; Ахтямов, И. Ф.; Коваленко, А. Н.; Загородний, Н. В.; Mironov, S P

doi:10.47360/1995-4484-2020-637-645

Cited by 12 publications

(2 citation statements)

References 66 publications

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“…Тотальное эндопротезирование тазобедренного сустава (ТЭТС) показано на поздних стадиях остеонекроза, то есть когда произошли коллапс головки бедренной кости и, как следствие, формирование вторичного ОА [9,10]. В настоящее время ТЭТС является наиболее широко используемым хирургическим методом при лечении аваскулярного некроза головки бедренной кости III-IV стадии по классификации ARCO [11].…”

Section: обоснованиеunclassified

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Panin

Zagorodniy

Boiko

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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BACKGROUND: Nowadays total hip arthroplasty (THA) is the method of choice for the treatment of late stages osteonecrosis of the femoral head (OFH) and osteoarthritis (OA) of the hip joint. OBJECTIVE: To evaluate the efficacy and complication pattern of THA in late stages of OFH and OA. MATERIALS AND METHODS: The study included 74 patients who underwent primary THA for OA stages IIIIV (Kellgren and Lawrence classification) and for OFH stages IIIIV (ARCO classification). Group 1 included 34 patients with OFH stages IIIIV, and group 2 40 patients with OA stages IIIIV. The groups were comparable by gender and age. All patients underwent implantation of endoprosthesis components using press-fit fixation with a metalpolyethylene articulation. Treatment results were assessed with regard to the incidence of complications and functional results at 3, 6 months, 1 and 3 years after THA. RESULTS: In our study, the survival rate of components after THA within 3 years after implantation was 100%. No cases of periprosthetic fracture, periprosthetic infection, and aseptic instability of endoprosthesis components were observed in both groups. The surface inflammation of the postoperative wound was detected in 1 (2.9%) patient in the OFH group and in 1 (2.5%) patient in OA group. Dislocation of the endoprosthesis occurred in 1 patient with OFH; there were no such findings in the OA group. The frequency of peri-implant osteolysis was twice lower (2.5%) in patients with OA compared to OFH group (5.8%). There were no statistically significant differences in the functional results dynamics before and after surgery between the groups (Harris score). The average Harris scale score in patients with OFH was 63 and reached 94 after 3 years; in OA group 58 and 94, respectively. CONCLUSION: THA is an alternative method in the treatment of severe hip arthroplasty. Endoprosthetics using a cementless endoprosthesis with a metalpolyethylene articulation demonstrated high efficacy as well as a low number of complications among patients with OFH and OA. We found no significant difference in THA results in terms of survival, postoperative complications, and functional outcome in patients with OFH and OA. Longer postoperative follow-up is advisable, which may allow us to establish some differences in treatment outcomes.

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Section: обоснованиеunclassified

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Panin

Zagorodniy

Boiko

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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“…These effects are explained by a slowdown in viral replication rates and an increase in the concentration of anti-inflammatory cytokines [64]. However, this mechanism of action of cholecalciferol has a weak base of evidence, as follow-up and clinical studies on the effects of Vitamin D and The associated risk of respiratory infections are the opposite: some report a decrease in risk, while others do not [65,66]. These conflicting results are thought to be related to the heterogeneity of the patient population and the dose of vitamin D. Therefore, the results of well-developed tests of Vitamin D should be expected before drawing conclusions about their possible effect on the body.…”

Section: Treatment Of Avascular Necrosis Of Femoral Head Associated W...mentioning

confidence: 99%

Complex-Conservative Treatment of Sars-Cov-2 Associated Early-Stage Avascular Necrosis of The Femoral Head

M.Yu. Karimov,

J.Sh. Kayumov

2023

Texa. Jour. of Medi. Scie.

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Avascular necrosis of bones (osteonecrosis) has developed as a bad consequence of the COVID-19 (SARS-CoV-2) pandemic that has swept the world. In 5-58% of patients with the type of covid19 fertilizer, the bones were affected by avascular necrosis. In 39% of patients with SARS-CoV-2, avascular necrosis of the hip bone developed within a few months after atypical pneumonia. Avascular necrosis is a disease that often develops in people of working age (average age is 33-45 years) and leads to severe disability associated with the death of bone tissue in a particular area. Discussions about the pathogenesis of postcovid avascular necrosis, the possibility of its diagnosis and treatment in the early stages are subject to active discussion. Given that COVID-19 infection is common among young people and working-age people, early diagnosis and treatment of this form of osteonecrosis is of great social and economic importance

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Osteonecrosis in Patients Recovering from COVID-19: Mechanisms, Diagnosis, and Treatment at Early-Stage Disease (Review)

Торгашин

Родионова

2022

Traumatology and Orthopedics of Russia

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Avascular necrosis (osteonecrosis) after COVID-19 is becoming the cause of severe pain in the hip, knee, shoulder joints with impaired their function. At the same time, the possibility of treating the disease in the early stages, give reason to believe that increasing the awareness of doctors about the pathology, methods of early diagnosis and treatment will reduce the risk of developing an advanced stage of aseptic necrosis after suffering COVID-19 and even prevent the need for joint replacement.The form of osteonecrosis after suffering COVID-19 should be classified according like another secondary osteonecrosis.This review provides data on the possible mechanisms of the development of osteonecrosis in patients after COVID-19, substantiates the need to perform an MRI study for early detection of pathology, and metods combined treatment. The pandemic made this data presented for doctors very actuality.

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Treatment of aseptic necrosis of the femoral head. Clinical guidelines

Cited by 12 publications

References 66 publications

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Total hip arthroplasty in the treatment of severe stages of osteonecrosis of the femoral head and osteoarthritis: results and complications

Complex-Conservative Treatment of Sars-Cov-2 Associated Early-Stage Avascular Necrosis of The Femoral Head

Osteonecrosis in Patients Recovering from COVID-19: Mechanisms, Diagnosis, and Treatment at Early-Stage Disease (Review)

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