scholarly journals Extensive Recontouring of the Femoral Head with Osteochondral Allografting: A Case Report with Histological and MicroCT Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Amir A. Jamali ◽  
Douglas Rowland ◽  
Kristen N. Vandewalker
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Posttraumatic Growth ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Case Reports ◽  
Young Patients ◽  
Osteochondral Allograft ◽  
Microct Analysis ◽  
Osteochondral Allografts

Morphological abnormalities such as cam deformity or growth disturbances can have a detrimental effect on the smooth function of the hip joint. This case reports an attempt to salvage the hip joint of a young patient with a posttraumatic growth disturbance of the femoral head using a fresh osteochondral allograft. This treatment has been used very rarely in the femoral head due to the presumed tenuous blood supply of the head and the perceived risk of nonunion or progressive avascular necrosis. The patient in this case had persistent pain and mechanical symptoms leading to hip replacement. A detailed analysis of the retrieved femoral head demonstrated durability and healing of the grafts based on gross inspection, histology of bone and cartilage, and microCT analysis. This case is the first report to our knowledge of a detailed histological and radiographic analysis of the fate of osteochondral allografts of the femoral head. We hope that this case provides justification for the use of osteochondral allografts of the femoral head for other indications such as femoral head fractures, avascular necrosis, and benign epiphyseal tumors of the femoral head in an effort to avoid arthroplasty in young patients. The authors have obtained the patient’s informed written consent for print and electronic publication of the case report.

Results of applying minimally invasive two-stage decompression with bone alloplasty for avascular necrosis of the femoral head

2021 ◽  
Vol 19 (3) ◽  
pp. 69-74
Author(s):  
A. V. ANTONOV ◽  
◽  
V. E. VOLOVIK ◽  
A. G. RYKOV ◽  
S. N. BEREZUTSKIY ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Minimally Invasive ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Rapid Development ◽  
Young Patients ◽  
Walking Distance ◽  
Joint Function ◽  
Two Stage

Avascular necrosis of the femoral head is a complex medical and social problem. The rapid development of the disease, the complexity of diagnosis and the prevalence among young patients leads to impaired hip joint function and further disability. To improve the quality of life of patients, the Orthopedic Department of the Traumatology Center of Khabarovsk developed a method of minimally invasive two-stage decompression. Surgical treatment was performed in 30 cases in patients with ANFH of stages 0, 1, 2 (by ARCO). Evaluation of treatment results was carried out before operative treatment, after 6 and 12 months. 12 months after surgical treatment, positive dynamics was noted, namely, pain reduction, a walking distance increase, abandonment of crutches, opportunity to use public transport, ability to sit for a long time in one and the same position, to put on shoes, and the abandonment of constant intake of non-steroidal anti-inflammatory drugs. The assessment of hip joint function in 20% of cases showed an excellent result, in 26,6% of cases — a good result, in 40% — satisfactory, and in 13,3% (4 people) — unsatisfactory result, which proves the effectiveness of the proposed treatment method and the feasibility of its use.

scholarly journals Corticosteroid induced avascular necrosis and COVID-19: The drug dilemma

2021 ◽  
Vol 11 (3) ◽  
pp. 1049-1052
Author(s):  
Indrajit Banerjee ◽  
Jared Robinson ◽  
Brijesh Sathian
Keyword(s):  
Adverse Effect ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Steroid Therapy ◽  
Case Reports ◽  
Weight Bearing ◽  
Inflammatory Cells ◽  
High Dose ◽  
Intraosseous Pressure ◽  
Femoral Head Osteonecrosis

The severe and life-threatening nature of the COVID-19 infection, the ARDS (acute respiratory distress syndrome) as well as the cytokine storm induced by the infection, commands lifesaving high doses of steroid therapy. As in all pharmacological therapies adverse effects are present. One such adverse effect which is being reported is corticosteroid induced avascular necrosis of the femoral head/ osteonecrosis of the femoral head. It must be noted that AVN principally affects the femoral head and most commonly the anterolateral aspect thereof as it is the crux of weight bearing.  Corticosteroids induce fat mobilization and this thus innately enhances the likelihood of fat emboli developing from the liver to occlude minor blood vessels in the femur, this thereby compromises the microvascular environment. Superadded to this the steroid therapy disrupts calcium metabolism and homeostasis which induces hypertrophy in the intramedullary fat cells, Gaucher cells and inflammatory cells; whilst increasing the activity of osteoclasts, thus increasing bone resorption and decreasing calcium uptake and deposition; ultimately leading to an insufficiency in the trabecular and cortical bone. This insufficiency thus equates to an increased intraosseous pressure which impedes intramedullary circulation and results in avascular necrosis.  It is evident that avascular necrosis is directly caused by high dose steroid therapy, however the case reports have very clearly indicated that the rapid onset of AVN post recovery from the COVID-19 infection cannot be solely attributed to steroid therapy and that another benefactor induced by the COVID-19 infection is at play. It is thus vital for treating physicians to take cognisance of this adverse effect post recovery and therefore should ensure that prophylactic bisphosphonate therapy is initiated timeously and congruently.

Osteochondral allograft in a femoral head chondroblastoma: A case report

2010 ◽  
Vol 20 (2) ◽  
pp. 280-283 ◽  
Author(s):  
Stefano Stilli ◽  
Leonardo Marchesini Reggiani ◽  
Luca Boriani ◽  
Onofrio Donzelli
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Osteochondral Allograft

scholarly journals Septic Arthritis of the Hip Joint in Cervical Cancer Patients after Radiotherapy: Three Case Reports

2001 ◽  
Vol 9 (2) ◽  
pp. 41-45 ◽  
Author(s):  
Shu-Hua Yang ◽  
Rong-Sen Yang ◽  
Chin-Lin Tsai
Keyword(s):  
Cervical Cancer ◽  
Femoral Head ◽  
Septic Arthritis ◽  
Cancer Patients ◽  
Hip Joint ◽  
Defense Mechanisms ◽  
Case Reports ◽  
Causative Organism ◽  
Total Hip ◽  
Hip Arthroplasties

Cervical cancer patients may experience hip problems related to the cancer itself or therapeutic management for the cancer. Septic arthritis should be one of the possibilities but there have been no reports on this. Here we present three patients who developed hip problems more than two years after radiotherapy with or without a radical operation. One patient was managed as septic arthritis because of significant inflammatory signs around the affected hip joint even though the causative organism was not confirmed. Succeeding total hip arthroplasty functioned well and had no recurrence of infection. The hip problems of the other two patients were diagnosed as radiation osteonecrosis of the femoral head initially. However, Bacteroides fragilis infection was found several months after total hip arthroplasties. Radiotherapy to the pelvis may damage the hip joint and compromise host-defense mechanisms of the pelvic region. Both factors may increase the possibility of infection of hip joints. Further clinical evidence is needed to understand whether subacute or chronic anaerobic infection could also be one of the causes leading to progressive destruction of the femoral head.

scholarly journals PIGMENTED VILLONODULAR SYNOVITIS OF THE HIP JOINT SHOWING EXTENSIVE DESTRUCTION OF THE FEMORAL HEAD : A CASE REPORT

1996 ◽  
Vol 46 (1) ◽  
pp. 63-66
Author(s):  
OSAMU YANAGISAWA ◽  
TETSUYA SHINOZAKI ◽  
JUNNICHI OSADA ◽  
TETSUO OGIWARA ◽  
EIICHI UDAGAWA
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Hip Joint ◽  
Pigmented Villonodular Synovitis ◽  
Villonodular Synovitis ◽  
Pigmented Villonodular
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