scholarly journals Porous tantalum implant for treatment of early-stage osteonecrosis of the femoral head: a minimum 5-year follow-up study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu Zhang ◽  
Wang Chen ◽  
Zhi Yang ◽  
Jian-Ning Sun ◽  
Zheng-Hao Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Femoral Head ◽  
Bone Marrow Edema ◽  
Operation Time ◽  
Harris Hip Score ◽  
Porous Tantalum ◽  
Imaging Results ◽  
Marrow Edema

Abstract Background To evaluate the survival rate of porous tantalum rod implantation in the treatment of osteonecrosis of the femoral head (ONFH), evaluate its clinical effect and imaging results. Methods From January 2008 to December 2013, porous tantalum rod implantation for ONFH was performed in two institutions. Statistical analysis of operation data, including operation time, blood loss and blood transfusion were recorded. Results 52 hips received complete follow-up, the average follow-up time was 85.7 months (60–132 months). 24 hips turned to THA at the end of follow-up (46.2%), the average time was 44.3 ± 32.8 months, and the average Harris hip score before THA was 57.1 ± 7.6. Cox proportional-hazards model revealed that Association Research Circulation Osseous (ARCO) stage (P = 0.017), bone marrow edema (P = 0.006) and age > 40 years (P = 0.043) were independent risk factors for conversion to THA. Conclusion ARCO stage, age and bone marrow edema were risk factors for the failure of porous tantalum rod implantation to convert to THA.

scholarly journals Porous Tantalum Implant for Treatment of Early-stage Osteonecrosis of the Femoral Head: A Minimum 5-year Follow-up Study

2020 ◽  
Author(s):  
Yu Zhang ◽  
Jian-Ning Sun ◽  
Zhi Yang ◽  
Wang Chen ◽  
Zheng-Hao Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Femoral Head ◽  
Bone Marrow Edema ◽  
Clinical Effect ◽  
Operation Time ◽  
Porous Tantalum ◽  
Imaging Results ◽  
Marrow Edema

Abstract Background To evaluate the survival rate of porous tantalum rod implantation in the treatment of osteonecrosis of the femoral head, to evaluate its clinical effect and imaging results, and to analyze the reasons for its failure to conversion to total hip arthroplasty (THA).Methods From January 2008 to December 2013, tantalum rod implantation for osteonecrosis of the femoral head was performed in two institutions. Statistical analysis of operation data, including operation time, blood loss and blood transfusion. Histopathological observations were performed on femoral head specimens with the tantalum rods that failed THA after tantalum rod implantation.Results 52 hips were followed up completely, the average follow-up time was 85.7 months (60-132 months). 24 hips turned to THA at the end of follow-up (46.2%), the average time was 44.3±32.8 months, and the average Harris score before THA was 57.1±7.6. Cox proportional-hazards model revealed that ARCO stage (P=0.017), bone marrow edema (P=0.006) and age＞40 years(P=0.043)were independent risk factors for conversion to THA. Histopathological examination revealed the implant surface is in contact with sparse Island bone. There is limited bone tissue extending inward from the implant.Conclusion The medium and long-term clinical effect of tantalum rod implantation in the treatment of osteonecrosis of the femoral head is not as satisfactory as we expected, and the osteogenic activity of tantalum rod in the femoral head is limited. ARCO stage, age and bone marrow edema were risk factors for the failure of tantalum rod implantation to THA.

scholarly journals Clinical Outcome and Histopathologic Evaluations of Porous Tantalum Implant for the Treatment of Early-Stage Osteonecrosis

2020 ◽  
Author(s):  
Yu Zhang ◽  
Jian-Ning Sun ◽  
Ye Zhang ◽  
Zi-Jian Hua ◽  
Shuo Feng ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Clinical Effect ◽  
Histopathological Examination ◽  
Operation Time ◽  
Harris Hip Score ◽  
Porous Tantalum ◽  
Imaging Results ◽  
Harris Score

Abstract Background To evaluate the survival rate of porous tantalum rod implantation in the treatment of avascular necrosis of the femoral head, to evaluate its clinical effect and imaging results, and to analyze the reasons for its failure to return to total hip arthroplasty (THA). Methods From January 2008 to December 2013, tantalum rod implantation for avascular necrosis of the femoral head was performed in two institutions. Statistical analysis of operation data, including operation time, blood loss and blood transfusion. Harris hip score and imaging results were evaluated. Kaplan Meier survival analysis was performed with THA as the end point. Histopathological observations were performed on femoral head specimens with the tantalum rods that failed THA after tantalum rod implantation. Results 42 patients (52 hips) were followed up completely, the average follow-up time was 74.3 months (60-120 months). 24 hips turned to THA at the end of follow-up (46.2%), the average time was (44 ± 32) months, and the average Harris score before THA was (57 ± 10). The follow-up time of 28 patients without THA was 78.6 ± 13.8 months, and the average Harris score was 80.6 ± 2.8. Histopathological examination revealed the implant surface is in contact with sparse Island bone. There is limited bone tissue extending inward from the implant. In the living bone area, there was “on-growth” of new bone but no “in-growth”. In the necrotic area, there was no obvious new bone regeneration. Conclusion The mid-and-long term clinical effect of tantalum rod implantation in the treatment of avascular necrosis of the femoral head is not good, and the osteogenic activity of tantalum rod in the femoral head is limited. ARCO stage, age and bone marrow edema were risk factors for the failure of tantalum rod implantation to THA.

MR Imaging of Bone Marrow Edema and Joint Effusion in Patients with Osteonecrosis of the Femoral Head: Relationship to Pain

2003 ◽  
Vol 181 (2) ◽  
pp. 545-549 ◽  
Author(s):  
Guo-Shu Huang ◽  
Wing P. Chan ◽  
Yue-Cune Chang ◽  
Cheng-Yen Chang ◽  
Cheng-Yu Chen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Mr Imaging ◽  
Bone Marrow Edema ◽  
Joint Effusion ◽  
Marrow Edema

Increased Perfusion of the Femoral Head in Transient Bone Marrow Edema Syndrome

2002 ◽  
Vol 402 ◽  
pp. 171-175 ◽  
Author(s):  
Kyung-Hoi Koo ◽  
In-Oak Ahn ◽  
Hae-Ryong Song ◽  
Shin-Yoon Kim ◽  
John Paul Jones
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Bone Marrow Edema ◽  
Bone Marrow Edema Syndrome ◽  
Transient Bone Marrow Edema ◽  
Marrow Edema

scholarly journals A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Shih-Jie Lin ◽  
Tsan-Wen Huang ◽  
Po-Chun Lin ◽  
Feng-Chih Kuo ◽  
Kuo-Ti Peng ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Large Scale ◽  
Operation Time ◽  
Harris Hip Score ◽  
Total Hip ◽  
Radiographic Parameters

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p<0.05for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

Hip Arthroscopic Management Can Improve Osteitis Pubis and Bone Marrow Edema in Competitive Soccer Players With Femoroacetabular Impingement

2019 ◽  
Vol 47 (2) ◽  
pp. 408-419 ◽  
Author(s):  
Masayoshi Saito ◽  
Hajime Utsunomiya ◽  
Akihisa Hatakeyama ◽  
Hirotaka Nakashima ◽  
Haruki Nishimura ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Femoroacetabular Impingement ◽  
Bone Marrow Edema ◽  
Soccer Players ◽  
Harris Hip Score ◽  
Osteitis Pubis ◽  
Arthroscopic Management ◽  
Modified Harris Hip Score ◽  
Marrow Edema

Background: There is a dearth of knowledge regarding the correlation between femoroacetabular impingement (FAI) and osteitis pubis (OP) among symptomatic soccer players. Purpose: To elucidate whether arthroscopic FAI correction is effective for young competitive soccer players with FAI combined with OP or perisymphyseal pubic bone marrow edema (BME). Study Design: Case series; Level of evidence, 4. Methods: A total of 577 consecutive patients who underwent arthroscopic FAI correction were retrospectively reviewed with a minimum 2-year follow-up. Competitive soccer players who were professional, college, and high school athletes were included. The authors assessed the modified Harris Hip Score and Nonarthritic Hip Score preoperatively and at 6 months, 1 year, and 2 years after surgery. In addition, players were divided into groups according to radiographic evidence of OP and BME (2 groups each). Clinical outcomes, return to play, and radiographic assessments were compared between groups. Results: Twenty-eight hips met the inclusion criteria. The median modified Harris Hip Score significantly improved after hip arthroscopy (81.4, preoperatively; 95.7 at 6 months, P = .0065; 100 at 1 year, P = .0098; 100 at 2 years, P = .013). The median Nonarthritic Hip Score also significantly improved (75.0, preoperatively; 96.3 at 6 months, P = .015; 98.8 at 1 year, P = .0029; 100 at 2 years, P = .015). Furthermore, 92.0% of players returned to play soccer at the same or higher level of competition at a median 5.5 months (range, 4-15 months); 67.8% had radiological confirmation of OP; and 35.7% had pubic BME. The alpha angle was significantly higher in pubic BME group than the no–pubic BME group (64.8° vs 59.2°, P = .027), although there was no significant difference between the OP and no-OP groups. The prevalence of tenderness of the pubic symphysis significantly decreased preoperatively (32.1%) to postoperatively (3.6%). Magnetic resonance imaging findings confirmed that pubic BME disappeared in all players at a median 11 months (range, 6-36) after initial surgery. Conclusions: Arthroscopic management for FAI provides favorable clinical outcomes, a high rate of return to sports, and, when present, resolution of pubic BME among competitive soccer players.

AN ACUTE FRACTURE OF THE FEMORAL NECK COMPLICATING BONE MARROW EDEMA IN OSTEONECROSIS OF THE FEMORAL HEAD, TREATED WITH TOTAL HIP REPLACEMENT

2010 ◽  
Vol 13 (01) ◽  
pp. 39-42
Author(s):  
Itay Fenichel ◽  
Moshe Salai ◽  
Steven Velkes
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Femoral Neck ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Bone Marrow Edema ◽  
Transient Osteoporosis ◽  
Total Hip ◽  
Regional Migratory Osteoporosis ◽  
Marrow Edema

Bone marrow edema is a sign that can be accompanied with osteonecrosis of the femoral head. There is still controversy as to whether it is a reversible form of avascular necrosis or it is a disease entity of its own. The probability and extent of the edema correlate well with the pain and stage of the necrosis. Unlike transient osteoporosis of the hip and regional migratory osteoporosis which are spontaneously resolving conditions, osteonecrosis can cause significant changes in the hip joint. We present a case of a displaced fracture of the femoral neck complicating bone marrow edema in osteonecrosis of the femoral head, in a 42-year-old man, treated with a cementless total hip replacement. This case emphasizes a potential complication associated with the state of diffuse bone marrow edema of the hip.

scholarly journals The role of bone marrow edema on autologous matrix induced chondrogenesis for the treatment of osteochondral lesions of the talus

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Marrow ◽  
Repeated Measures ◽  
Bone Marrow Edema ◽  
Lesion Size ◽  
Osteochondral Lesions ◽  
Significant Difference ◽  
T1 And T2 ◽  
Marrow Edema

Category: Ankle, Arthroscopy, Basic Sciences/Biologics Introduction/Purpose: to assess the functional and radiological outcomes after AT-AMIC® (arthroscopic talus autologous matrix induced chondrogenesis) in 2 groups: patients with and without bone marrow edema (BME). Methods: Thirty-seven patients of which 24 without edema (GNE) and 13 with edema (GE) were evaluated. All patients were treated with AT-AMIC® repair for osteochondral talar lesion. MRI and CT-scan evaluations, as well as clinical evaluations measured by the VAS score for pain, AOFAS and SF-12 were performed preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively. Results: GNE consisted of 24 patients while GE consisted of 13 patients. In both groups we found a significant difference for clinical and radiological parameters with ANOVA for repeated measures through four time points(p<0.001). In GNE, AOFAS improved significantly at each follow-up(p<0.05); while CT and MRI showed a significant decrease between T1 and T2 and T2 and T3(p<0.05). In GE, AOFAS improved significantly between T0 and T1 and T2 and T3(p<0.05); CT decreased between T1 and T2(p<0.05), while MRI showed a reduction at each follow-up(p<0.05). Lesion size was significantly higher both in MRI and CT in GE in respect to GNE(p<0.05). In the GNE no patients presented edema at T3, while in GE only 23.08% of the patients presented edema at T3. Conclusion: The study revealed that osteochondral lesions of the talus were characterized by bigger size both in MRI and CT in patients with edema. We conclude that AT-AMIC® can be considered a safe and reliable procedure that allows effective healing, regardless of edema and more than half of patients did not present edema six months after surgery.

scholarly journals Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Tim Claßen ◽  
Antonia Becker ◽  
Stefan Landgraeber ◽  
Marcel Haversath ◽  
Xinning Li ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Total Joint Replacement ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Avascular Osteonecrosis ◽  
Surgical Methods ◽  
Advanced Stages ◽  
Subjective Complaints ◽  
Marrow Edema

The treatments of avascular osteonecrosis (AVN) include both conservative and surgical methods which are dependent on the stage and progression of the disease. The vasoactive- prostaglandin-analogue iloprost (PGI2) has been utilized in several areas of medicine and recently has been used for the treatment of AVN. A total of 108 patients with 136 osteonecrosis of different joints, etiology and severity were treated with iloprost. The mean follow-up was 49.71 months: range 15-96 months, and outcome measurements recorded regarding subjective complaints, visual analog scale (pain), function and survival. The outcome scores used include the Harris Hip Score, Knee Society score, Foot and Ankle Survey, visual analogue scale (VAS) and a separate questionnaire. The location and etiology of AVN in our study demonstrated the typical pattern. All of the observed side effects of the therapy were minor and completely reversible. Most of patients (74.8%) showed a significant improvement of subjective complaints and decrease in VAS pain scores after the treatment with iloprost. However, 20% of the treated joints with the stadium Association for Research on Osseous Circulation (ARCO) grade 2, 71% with ARCO 3 and 100% with ARCO 4 underwent subsequent total joint replacement. The medical treatment of bone marrow edema or avascular osteonecrosis by Iloprost provides an safe and effective alternative strategy in the management of AVN presenting in the early stages (ARCO 1 or 2). For more advanced stages (ARCO 3 or 4), surgical intervention should be prioritized.

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