Advanced core decompression, a new treatment option of avascular necrosis of the femoral head - a first follow-up

2012 ◽  
Vol 7 (11) ◽  
pp. 893-900 ◽  
Author(s):  
Stefan Landgraeber ◽  
Jens M. Theysohn ◽  
Tim Classen ◽  
Marcus Jäger ◽  
Sebastian Warwas ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Treatment Option ◽  
Core Decompression ◽  
New Treatment

scholarly journals Core decompression with bone chips allograft in combination with fibrin platelet-rich plasma and concentrated autologous mesenchymal stromal cells, isolated from bone marrow: results for the treatment of avascular necrosis of the femoral head after 2 years minimum follow-up

2020 ◽  
Vol 30 (2_suppl) ◽  
pp. 3-12
Author(s):  
Martina Rocchi ◽  
Nicoladrea Del Piccolo ◽  
Alessandro Mazzotta ◽  
Gianluca Giavaresi ◽  
Milena Fini ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Platelet Rich Plasma ◽  
Core Decompression ◽  
Joint Surface ◽  
Harris Hip Score ◽  
Functional Scores

Introduction: Avascular necrosis of femoral head (AVN) is 1 of the main factors causing disability in young adults. Hip prosthesis can be considered an effective treatment of the painful symptoms but it is a major surgical intervention for this type of population. Thus, a large space should be left to therapeutic alternatives such as regenerative medicine. This retrospective study evaluates 52 AVN treated by core decompression, bone chips allograft, fibrin platelet-rich plasma (PRF) and concentrated autologous mesenchymal stromal cells (MSCs). Methods: The AVN was diagnosed using magnetic resonance imaging (MRI) and graded according to ARCO classification: a patient was classified stage 1 (21 patients), stage 3 (26 patients), and 4 patients were classified as stage 4. We evaluated patients with functional scores (Harris Hip Score) and radiological analysis at 3, 6, 12 and 24 months after the procedure. Patients requiring prosthetic replacement of the joint were included; in these cases, follow-up was interrupted at the time of the joint replacement procedure. Results: Our statistical analysis showed differences between survived and failed treatments, in terms of patient profile and ARCO radiological classification. The best result occurred in patients with ARCO grades 1 and 2, while the more advanced grades showed a high failure rate. It is interesting to note that ARCO quantification, conceived as the joint surface involved in the necrosis, has a negative influence on the outcome of the procedure. Indeed, patients affected by ARCO 3a, where necrosis involved a small portion of the femoral epiphysis and the collapse of the articular surface was limited to 2 mm, showed results similar to those obtained in patients with ARCO 1 and 2. Conclusions: In conclusion, compared with the alternative technique of decompression, our data suggest that post-collapse cases with a small area of necrosis and the use of bone grafts may show better results compared to those of the literature.

scholarly journals A Functional and Radiological Outcome Analysis of Hip Forage Procedure, done for Early Stages(Ficat and Arlet Grade 1 and 2A) of Avascular Necrosis of Head of Femur

2021 ◽  
pp. 97-105
Author(s):  
Shubham Padmawar ◽  
Dr. Suhas Landge ◽  
Prateek Upadhyay ◽  
Mitali Madhusmita
Keyword(s):  
Femoral Head ◽  
Disease Progression ◽  
Avascular Necrosis ◽  
Core Decompression ◽  
Foot Drop ◽  
Harris Hip Score ◽  
Moderate Pain ◽  
Radiological Outcome ◽  
Mild Pain

Background: Avascular necrosis of the femoral head is a severe disease and causes osteoarthritis of the hip joint in young adults. Early diagnosis leads to better prognosis and therapeutic success. Aim: To study pain, radiological outcome & functional outcome post hip forage procedure in patients of avascular necrosis of head of femur (Ficat and Arlet grade 1 and grade 2A). Study Design: This was a prospective observational study. Place and Duration of Study: Conducted in the Department of Orthopaedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Nerul, Navi Mumbai over a period of 2 years from 2015 to 2017 Methodology: We included 50 patients (39 males, 11 females) with Avascular necrosis of unilateral or bilateral head of femur (Grade 1 and Grade 2A), clinical, radiological and functional(with the help of Harris hip score) examination was done at 6 months and 12 months follow up post operatively.  Results: Out of the 50 patients, pre-peratively, 60% reported moderate pain, 20% mild pain and 20% severe pain. At follow-up, 36% patients reported slight pain, 26% mild pain, 26% moderate pain, 8% marked pain, and no pain was reported by 4% patients. Pre-operatively, no limp was seen in 34% patients, while 66% patient had a limp. At follow-up, 70% patient had a limp and no limp in 30% patients. Before surgery, support (cane use) was required by 6% patients, while at follow-up, support was noted by 12% patients. Preoperative mean Harris Hip Score was 63.6, while that at follow-up it was 74.74. Radiological worsening of the disease occurred only in 38% of the patients which suggests that disease progression was delayed in most patients(62%). 2% patients had a complication of foot drop. Conclusion: Avascular necrosis of femoral head is more common in young males. Core decompression by multiple drilling and/or core decompression with fibular strut grafting are equally effective in pre collapse stages (stage 1 and stage 2A) with better functional and radiological outcomes and hence these procedures can play a vital role in delaying the disease progression.

Necrosis avascular

2020 ◽  
Vol 63 (2) ◽  
pp. 18-23
Author(s):  
Alejandro Jardón Gómez ◽  
Ana Cristina King ◽  
Carlos Pacheco Díaz
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Femoral Fracture ◽  
Open Fracture ◽  
Clinical Presentation ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Young Population ◽  
Steroid Use

The clinical presentation of a proximal femoral fracture is completely different between young and adult patients. Unlike closed proximal femoral fractures, the incidence of exposed fractures is found in the young population between 15 and 30 years of age. Osteonecrosis of the femoral head is one the complications we can find in this type of fractures. Avascular necrosis (AVN or osteonecrosis) is defined as the interruption of blood supply to the femoral head due to trauma, infectionalcohol or steroid use, resulting in bone necrosis, joint collapse and osteoarthrosis. The treatment will depend on the clinical presentation, age of the patient and when the diagnosis is made. This is a case report of a 16-year-old patient with a gunshot wound on the hip. Surgical cleansing and closed reduction plus internal fixation with a nail in the center of the spine were performed. A 3-year clinical and radiographic follow up was made, observing the evolution of the fracture and the subsequent avascular necrosis that the patient presented. Key words: Proximal femoral fracture; hip; avascular necrosis (AVN, osteonecrosis); open fracture; osteoarthritis.

scholarly journals Modifications to advanced Core decompression for treatment of Avascular necrosis of the femoral head

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Stefan Landgraeber ◽  
Sebastian Warwas ◽  
Tim Claßen ◽  
Marcus Jäger
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Core Decompression

scholarly journals The results of core decompression treatment in patients with avascular necrosis of femoral head in patients at Isfahan City educational hospitals in 2010-2011

2014 ◽  
Vol 3 (1) ◽  
pp. 93 ◽  
Author(s):  
Mehdi Kooskzari ◽  
MehrabiKooshki Ali ◽  
Khalilollah Nazem ◽  
Behnamoon Mahsa ◽  
Mohammadreza Etemadifar
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Core Decompression ◽  
Necrosis Of Femoral Head
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