The Role of99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

Objective. To validate the ability of99mTc-Annexin V to visualize early stage of glucocorticoid-induced femoral head necrosis by comparing with99mTc-MDP bone scanning.Methods. Femoral head necrosis was induced in adult New Zealand white rabbits by intramuscular injection of methylprednisolone.99mTc-Annexin scintigraphy and99mTc-MDP scans were performed before and 5, 6, and 8 weeks after methylprednisolone administration. Rabbits were sacrificed at various time points and conducted for TUNEL and H&E staining.Results. All methylprednisolone treated animals developed femoral head necrosis; at 8 weeks postinjection, destruction of bone structure was evident in H&E staining, and apoptosis was confirmed by the TUNEL assay. This was matched by99mTc-Annexin V images, which showed a significant increase in signal over baseline. Serial99mTc-Annexin V scans revealed that increased99mTc-Annexin V uptake could be observed in 5 weeks. In contrast, there was no effect on99mTc-MDP signal until 8 weeks. The TUNEL assay revealed that bone cell apoptosis occurred at 5 weeks.Conclusion.99mTc-Annexin V is superior to99mTc-MDP for the early detection of glucocorticoid-induced femoral head necrosis in the rabbit and may be a better strategy for the early detection of glucocorticoid-induced femoral head necrosis in patients.

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Outcome after a new porous tantalum rod implantation for treatment of early-stage femoral head osteonecrosis

Annals of Translational Medicine ◽

10.21037/atm.2019.08.86 ◽

2019 ◽

Vol 7 (18) ◽

pp. 441-441 ◽

Cited By ~ 1

Author(s):

Wei Huang ◽

Xuan Gong ◽

Steve Sandiford ◽

Xiaoqiang He ◽

Feilong Li ◽

...

Keyword(s):

Femoral Head ◽

Early Stage ◽

Porous Tantalum ◽

Femoral Head Osteonecrosis

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High-energy extracorporeal shock wave therapy for early stage femoral head osteonecrosis

Medicine ◽

10.1097/md.0000000000021300 ◽

2020 ◽

Vol 99 (31) ◽

pp. e21300

Author(s):

Qing-hui Ji ◽

Shi-chen Liu ◽

Jie Miao ◽

Zhi-xin Ren ◽

Yu-fei Yuan ◽

...

Keyword(s):

Shock Wave ◽

Femoral Head ◽

Early Stage ◽

Extracorporeal Shock Wave Therapy ◽

High Energy ◽

Shock Wave Therapy ◽

Extracorporeal Shock Wave ◽

Femoral Head Osteonecrosis

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An animal model of early-stage femoral head osteonecrosis induced by cryo-insult in small tailed Han sheep

Journal of Orthopaedic Translation ◽

10.1016/j.jot.2020.06.004 ◽

2021 ◽

Vol 26 ◽

pp. 84-91

Author(s):

Cairu Wang ◽

Zhigang Wu ◽

Xiaokang Li ◽

Lei Shi ◽

Qingyun Xie ◽

...

Keyword(s):

Animal Model ◽

Femoral Head ◽

Early Stage ◽

Femoral Head Osteonecrosis

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Intertrochanteric Corrective Osteotomy as a Joint-Saving Surgical Treatment for Femoral Head Necrosis

Hip International ◽

10.1177/1120700094004003-401 ◽

1994 ◽

Vol 4 (3-4) ◽

pp. 101-114

Author(s):

B.J. Berendsen ◽

C.J. Wirth ◽

H.V.D. Boom

Keyword(s):

Femoral Head ◽

Hip Joint ◽

Joint Replacement ◽

Clinical Symptoms ◽

Early Stage ◽

Corrective Osteotomy ◽

Femoral Head Necrosis ◽

Hip Joint Replacement ◽

Total Hip

Forty-seven intertrochanteric osteotomies were performed in 9 years on 40 patients with femoral head necrosis in Arlet and Ficat stages II and III in the Orthopaedic Department of the Medical School, Hannover. With an average follow up of 5.9 years (minimum 2.3 years, maximum 9.3 years), the study shows only 46% of the patients with satisfactory, good and very good results. After the joint saving operation, 26% of treated patients with pre-operative employment went into premature retirement. The average postoperative non-working period was 11 months (7-18 months). Clinical Relevance The results after the joint-saving operation were better when the operation was performed at an early stage of the disease with only a small area of necrosis. Although the operation will not prevent a progression of necrosis and a secondary arthrosis, we recommend that the joint-saving operation be performed during stages I and II to prolong the period before a total hip joint replacement becomes necessary. During stage III a total hip joint replacement may be preferable depending on clinical symptoms, patient age and the radiological findings (necrosis angle > 180°).

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Early detection of steroid-induced femoral head necrosis using 99mTc-Cys-Annexin V-based apoptosis imaging in a rabbit model

Molecular Medicine ◽

10.1186/s10020-020-00248-1 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Xiaolong Wang ◽

Jianbo Li ◽

Da Man ◽

Rui Liu ◽

Jianmin Zhao

Keyword(s):

Femoral Head ◽

Photon Emission ◽

Rabbit Model ◽

Annexin V ◽

Spect Imaging ◽

Femoral Head Necrosis ◽

Terminal Deoxynucleotidyl Transferase ◽

Control Group ◽

Emission Computed Tomography ◽

Target Tissue

Abstract Background At present, the early diagnosis of femoral head necrosis mainly relies on Magnetic resonance imaging (MRI), and most early patients are difficult to make an accurate diagnosis. Therefore, to investigate the early diagnostic value of 99mTc-Cys-Annexin V Single-photon emission computed tomography (SPECT) imaging were compared with MRI in rabbit models of steroid-induced femoral head necrosis. Methods The animal model of steroid-induced femoral head necrosis (SIFHN) was established in 5-month-old healthy New Zealand white rabbits by injecting horse serum into ear vein and methylprednisolone into gluteal muscle, the purpose of modeling is to simulate the actual clinical situation of SIFNH. 99mTc-Cys-Annexin V SPECT imaging and MRI were performed at 2nd week, 4th week, and 6th week after modeling. After that, histopathology was used to verify the success of modeling. Apoptosis was detected by transmission electron microscopy (TEM) and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL). Results At 2 weeks after the injection of hormone, 99mTc-Cys-Annexin V SPECT image showed abnormal radioactive uptake in the bilateral femoral head. And over time, the radioactivity concentration was more obvious, and the ratio of T/NT (target tissue/non-target tissues, which is the ratio of femoral head and the ipsilateral femoral shaft) was gradually increased. In the 99mTc-Cys-Annexin V SPECT imaging at each time point, T/NT ratio of the model group was significantly higher than that of the control group (P < 0.01); at 4 weeks after the injection of hormone, MRI showed an abnormal signal of osteonecrosis. At 2, 4, and 6 weeks after hormone injection, apoptosis was observed by TUNEL and TEM. Conclusions 99mTc-Cys-Annexin V SPECT imaging can diagnose steroid-induced femoral head necrosis earlier than MRI, and has potential application value for non-invasively detecting early and even ultra-early stage of femoral head necrosis.

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Inhibitory effects of vitamin E on osteocyte apoptosis and DNA oxidative damage in bone marrow hemopoietic cells at early stage of steroid-induced femoral head necrosis

Molecular Medicine Reports ◽

10.3892/mmr.2017.6160 ◽

2017 ◽

Vol 15 (4) ◽

pp. 1585-1592 ◽

Cited By ~ 15

Author(s):

Yan-Bo Jia ◽

Dian-Ming Jiang ◽

Yi-Zhong Ren ◽

Zi-Hong Liang ◽

Zhen-Qun Zhao ◽

...

Keyword(s):

Bone Marrow ◽

Vitamin E ◽

Femoral Head ◽

Oxidative Damage ◽

Early Stage ◽

Femoral Head Necrosis ◽

Inhibitory Effects ◽

Hemopoietic Cells ◽

Osteocyte Apoptosis ◽

Dna Oxidative Damage

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Hip-preserving surgical treatment for atraumatic femoral head necrosis

Genij Ortopedii ◽

10.18019/1028-4427-2020-26-4-495-501 ◽

2020 ◽

Vol 26 (4) ◽

pp. 495-501

Author(s):

A.E. Murzich ◽

◽

O.A. Sokolovsky ◽

G.A. Uryev ◽

◽

...

Keyword(s):

Femoral Head ◽

Minimally Invasive ◽

Bone Grafting ◽

Young Patients ◽

Core Decompression ◽

Autologous Bone Marrow ◽

Femoral Head Necrosis ◽

Long Term Results ◽

Surgical Interventions ◽

Femoral Head Osteonecrosis

Introduction Hip-salvage treatment in femoral head necrosis has a great social and economic importance.The number of hip joint replacements in young patients has been increasing. Purpose To evaluate the results of hip-preserving surgical interventions in the treatment of patients with non-traumatic femoral head necrosis. Materials and methods The study included 42 cases treated by minimally invasive core decompression of the femoral head and bone grafting, 22 cases of decompression and introduction of autologous bone marrow and mesenchymal stem cells into the core of necrosis, and six cases of using a titanium locking mesh implant. Results The follow-up time after surgery was up to 5 years. The survival rate of hip-reserving operations using cell technology to stimulate osteoregeneration were noticeably better than using bone grafting only in disease stages I, IIA, IIB, IIC. For femoral head osteonecrosis in stage IIIA, a titanium locking femoral head implant has been developed. It promotes regeneration and performs a supporting function. Conclusion The analysis of long-term results of these minimally invasive technologies has proven their efficacy and safety along with a low rate of complications.

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Early Detection of Steroid-Induced Femoral Head Necrosis using 99mTc-Cys-Annexin V-based Apoptosis Imaging in a Rabbit Model

10.21203/rs.3.rs-31520/v1 ◽

2020 ◽

Author(s):

Xiaolong Wang ◽

Jianbo Li ◽

Da Man ◽

Rui Liu ◽

Jianmin Zhao

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Femoral Head ◽

Rabbit Model ◽

Annexin V ◽

Spect Imaging ◽

Femoral Head Necrosis ◽

Control Group ◽

Target Tissue ◽

Transmission Electron

Abstract Background At present, the early diagnosis of femoral head necrosis mainly relies on MRI, and most early patients are difficult to make an accurate diagnosis. Therefore, to investigate the early diagnostic value of 99mTc-Cys-Annexin V SPECT imaging were compared with MRI in rabbit models of steroid-induced femoral head necrosis. Methods The rabbit models of steroid-induced femoral head necrosis were established by intravenous injection of horse serum and gluteal muscle injection of methylprednisolone in of 5-month-old healthy New Zealand white rabbits. 99mTc-Cys-Annexin V SPECT imaging and MRI were performed at 2nd week, 4th week, and 6th week after modeling. After that, histopathology was used to verify the success of modeling. Apoptosis was detected by transmission electron microscopy and TUNEL. Results At 2 weeks after the injection of hormone, 99mTc-Cys-Annexin V SPECT image showed abnormal radioactive uptake in the bilateral femoral head. And over time, the radioactivity concentration was more obvious, and the ratio of T/NT (target tissue/non-target tissues) was gradually increased. In the SPECT imaging at each time point, T/NT ratio of the model group was significantly higher than that of the control group (P < 0.01); at 4 weeks after the injection of hormone, MRI showed an abnormal signal of osteonecrosis. At 2, 4, and 6 weeks after hormone injection, apoptosis was observed by TUNEL and transmission electron microscopy. Conclusions 99mTc-Cys-Annexin V SPECT imaging can diagnose steroid-induced femoral head necrosis earlier than MRI, and has potential application value for non-invasively detecting early and even ultra-early stage of femoral head necrosis.

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