scholarly journals Plasma and local expressions of CircRNA CDR1as are linked with disease severity in patients with non-traumatic osteonecrosis of femoral head

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bin Jiang ◽  
Shu-Hua Zhu ◽  
Ji-Yong Zeng ◽  
Zheng Mao
Keyword(s):  
Femoral Head ◽  
Disease Severity ◽  
Roc Curve ◽  
Radiographic Progression ◽  
Phase 1 ◽  
Clinical Severity ◽  
Harris Hip Score ◽  
Phase 3 ◽  
Osteonecrosis Of Femoral Head ◽  
Arco Classification

Abstract Objective To investigate the correlation of plasma and local expressions of Circ CDR1as with disease severity in patients with non-traumatic osteonecrosis of femoral head (ONFH). Methods Ninety-nine non-traumatic ONFH patients receiving surgery and 99 healthy individuals were enrolled in our study. Plasma and local Circ CDR1as were detected using real-time quantitative PCR (RT-qPCR). Radiographic progression was determined using Association Research Circulation Osseous (ARCO) classification system. Harris hip score (HHS) and visual analogue scale (VAS) were used to assess the clinical severity. Receiver operating characteristic (ROC) curve was carried out to evaluate the diagnostic value of plasma Circ CDR1as with regard to the radiographic severity. Results Plasma Circ CDR1as expressions were significantly higher in non-traumatic ONFH patients compared with healthy controls. In non-traumatic ONFH patients, there were no significant differences of CircCDR1as expressions between patients with alcohol-induced ONFH and steroid-induced ONFH. CircCDR1as in local necrotic tissue were significantly higher than adjacent non-affected tissue. Plasma and local Circ CDR1as expressions in patients with ARCO phase 4 were markedly upregulated compared with ARCO phase 3; plasma and local Circ CDR1as expressions in patients with ARCO phase 3 were markedly upregulated compared with ARCO phase 1/2. Plasma and local CircCDR1as expressions were positively associated with ARCO classification. In addition, plasma and local Circ CDR1as expressions were positively correlated with VAS and HHS scores. ROC curve analysis indicated that plasma Circ CDR1as may act as a decent marker for radiographic progression in non-traumatic ONFH patients. Conclusions Both plasma and local expressions of CircRNA CDR1as are linked with disease severity in patients with non-traumatic ONFH.

scholarly journals Attenuated serum vasoactive intestinal peptide concentrations are correlated with disease severity of non-traumatic osteonecrosis of femoral head

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ming Liu ◽  
Gan Zhao ◽  
Biao-Fang Wei
Keyword(s):  
Femoral Head ◽  
Vasoactive Intestinal Peptide ◽  
Disease Severity ◽  
Roc Curve ◽  
Radiographic Progression ◽  
Clinical Severity ◽  
Harris Hip Score ◽  
Negatively Associated ◽  
Tnf Α ◽  
Significant Difference

Abstract Background and objective The neuropeptide vasoactive intestinal peptide is a 28-amino acid neuropeptide that has been shown to stimulate bone repair and angiogenesis. The purpose of this study was to explore the potential role of serum VIP concentration in osteonecrosis of femoral trauma (ONFH). Methods One hundred five patients diagnosed with non-traumatic ONFH and 103 healthy individuals were enrolled in our study. Serum VIP, tumor necrosis factor-α (TNF-α), interluekin-1 beta (IL-1β), and macrophage colony-stimulating factor (M-CSF) levels also were detected using the commercial ELISA kit. Radiographic progression was evaluated using FICAT classification. The clinical severity of ONFH was assessed by visual analog score (VAS) and Harris Hip Score (HHS). Receiver-operating characteristic (ROC) curve was performed to test the potential diagnostic value of VIP in radiographic progression. Results The serum VIP level of patients with non-traumatic ONFH was significantly lower than that of healthy controls. There was no significant difference between the alcohol group, the steroid-induction group, and the idiopathic group. Serum VIP levels were significantly higher in ONFH patients with femoral head pre-collapse stage than collapse stage. Serum VIP levels were significantly lower. FICAT 4 non-traumatic ONFH patients had significantly lower serum concentrations of VIP when compared with FICAT 3 and FICAT 2. Moreover, serum VIP levels were significantly lower in ONFH patients with FICAT 3 than FICAT 2. Serum VIP levels were negatively related to FICAT stage. In addition, serum VIP levels were negatively associated with VAS score and positively associated with HHS score. Last, we found serum VIP levels were negatively associated with serum TNF-α and IL-1β levels. ROC curve analysis indicated that decreased serum VIP could serve as a decent biomarker with regard to the diagnosis of radiographic progression. Conclusion Attenuated serum VIP concentrations are correlated with disease severity of non-traumatic ONFH. Decreased serum VIP may serve as a potential indicator of non-traumatic ONFH.

scholarly journals The Glycosaminoglycan Content of Hip Cartilage in Osteonecrosis of Femoral Head: Evaluation with Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage

Cartilage ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Qidong Zhang ◽  
Wanshou Guo ◽  
Yan Chen ◽  
Qichao Zhao ◽  
Zhaohui Liu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Early Stage ◽  
Control Group ◽  
Resonance Imaging ◽  
Osteonecrosis Of Femoral Head ◽  
Joint Preserving Surgery ◽  
Hip Cartilage ◽  
Arco Classification

Objective Hip cartilage quality is essential for the success of joint-preserving surgery for osteonecrosis. This study aimed to characterize cartilage changes in osteonecrosis of femoral head (ONFH) using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). Design Fifteen asymptomatic (control) and 60 ONFH subjects were included in this study. The ONFH subjects were stratified in accordance with the Association Research Circulation Osseous (ARCO) classification ( n = 15 hips per ARCO stage). All participant hips were investigated using dGEMRIC and theT1Gd data were collected and analyzed. Results T1Gd value was significantly lower in the ONFH group (365.1 ± 90.5 ms; range 200-498 ms) compared with the control group (546.1 ± 26.0 ms; range 504-580 ms) ( P < 0.001). The T1Gd values of ARCO stage I-IV ONFH were 460.2 ± 17.3 ms (439-498 ms), 408.9 ± 43.4 ms (337-472 ms), 359.9 ± 34.5 ms (303-412 ms), 231.5 ± 15.1 ms (200-253 ms), respectively. Decreased T1Gd value was found to correlate significantly with increased ONFH severity ( P < 0.001). T1Gd value in collapse stage was significantly lower than that of noncollapse stage (295.7 ± 70.3 ms [range 200-412 ms] vs. 434.6 ± 41.7 ms [range 337-498 ms]; P < 0.001). Conclusions dGEMRIC identified hip cartilage as abnormal in ONFH, even at early-stage, as represented by decreased T1Gd, and this was further aggravated by ONFH collapse.

scholarly journals Treatment of osteonecrosis of femoral head in young patients by surface replacement of femoral head

2017 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Mahendra Kumar Reddy Mundla ◽  
Someswara Reddy Buchupalli ◽  
Srikar Reddy G. ◽  
Krishna Reddy S
Keyword(s):  
Femoral Head ◽  
Articular Surface ◽  
Young Patients ◽  
Stage Ii ◽  
Stage Iii ◽  
Harris Hip Score ◽  
Surface Replacement ◽  
Osteonecrosis Of Femoral Head ◽  
Number Of Patients ◽  
Articular Surface Replacement

<p><strong>Background: </strong>Osteonecrosis of hip is a pathological condition that affects usually young adults. Articular surface replacement (ASR) is considered to be a viable option in young patients. The study was done with the aim to analyse and to recommend the management of osteonecrosis of femoral head in young patients by surface replacement of femoral head as ideal procedure.</p><p><strong>Methods: </strong>The present study was conducted in 30 patients with osteonecrosis of the femoral head who attended to OPD at Santhiram Medical College and General Hospital, Nandyal, A.P during the period of April 2016 to September 2017. Articular surface replacement of the femoral head was the surgical procedure done in all the patients. The success of the treatment was analysed by Harris hip scoring.</p><p><strong>Results: </strong>Maximum number of patients (60%) was below 40 years of age. Male dominance (77%) was seen in the study. According to Ficat and Arlet classification 12 cases (40%) were under the category of stage II-B and 18 cases (60%) were of stage III. Postoperatively about 90% of patients had postoperative Harris hip score of &gt;80 points. Surgery was succeeded in 10 hips of stage II-B and 15 hips in stage III. According to Harris hip scoring excellent results were obtained in 15 (50%), good in 12 (40%), fair in 2 (6.67%) and poor result 1 (3.3%) patient.<strong></strong></p><p><strong>Conclusion: </strong>The study concludes that the surface replacement is an anatomical hip arthroplasty with preservations of more than 70% of bone stock of femoral head and the ability of the patients to sit cross-legged and squat, which is the desire of the Indian population.</p>

scholarly journals Free vascularized iliac bone flap based on deep circumflex iliac vessels graft for the treatment of osteonecrosis of femoral head

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Pengfei Lei ◽  
Wei Du ◽  
Hao Liu ◽  
Panfeng Wu ◽  
Zhengbing Zhou ◽  
...  
Keyword(s):  
Femoral Head ◽  
Iliac Bone ◽  
Bone Flap ◽  
Harris Hip Score ◽  
Osteonecrosis Of Femoral Head ◽  
X Ray ◽  
Circumflex Femoral Artery ◽  
Superficial Wound ◽  
Lateral Circumflex Femoral

Abstract Background To investigate the feasibility and clinical efficacy of free vascularized iliac bone flap based on deep iliac circumflex vessels graft for the treatment of osteonecrosis of femoral head (ONFH) in young adults. Methods Eighteen patients (19 hips) undergoing ONFH were included from January 2016 to May 2017. After the debridement of the necrotic bones, the contralateral vascularized iliac bone flap was designed and harvested before grafting, in which the deep circumflex iliac vessels and the transverse branch (or ascending branch) of the lateral circumflex femoral artery and their accompanying veins were anastomosed. X-ray was obtained at 1, 3, 6, 9, and 12 months respectively for evaluation of the bone flap healing. Hip function was evaluated with Harris hip score at 18 months postoperatively. Results None of the patients is lost to follow-up. All the hips healed well except for four complications: one patient developed superficial wound infection, one patient had subcutaneous hematoma, and two patients developed anterolateral femoral cutaneous nerve injury. X-ray films at 12 months showed improvement in 13 hips (68.4%), five hips (26.3%) were unchanged, and one femoral head collapse with conversion to total hip arthroplasty (THA) at 14 months postoperatively (5.3%). Postoperative mean Harris hip scores were significantly improved compared to the preoperative results (P < 0.05). Conclusion Free vascularized iliac bone flap based on deep circumflex iliac vessels graft is an acceptable treatment option for young adult ONFH in mid-late stage with low conversion to THA rate at short-term follow-up.

Tensor fascia lata muscle pedicle grafting for avascular necrosis femoral head

2016 ◽  
Vol 2 (4) ◽  
pp. 333 ◽  
Author(s):  
Mohamed Ashraf ◽  
Subramanian V. ◽  
Narayanan S. K. ◽  
Manu Mohan
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Fascia Lata ◽  
Harris Hip Score ◽  
Success Rates ◽  
Tensor Fascia Lata ◽  
Average Hospital ◽  
Osteonecrosis Of Femoral Head ◽  
Variable Success

<p class="abstract"><strong>Background:</strong> Osteonecrosis of femoral head (AVN) is a disabling condition with ill-defined etiology and pathogenesis. In more than 60% it leads to osteoarthritis of hip joint. Treatment for this condition includes both operative and non-operative methods with variable success rates. Surgical options being aimed at both conservation of femoral head and arthroplasty of hip joint. Aim of our study was to evaluate the efficacy of tensor fascia lata muscle pedicle grafting in the management of osteonecrosis of femoral head.</p><p class="abstract"><strong>Methods:</strong> 27 cases with a mean age of 38.7 years (range from 24 to 52) who underwent tensor fascia lata muscle pedicle grafting in the management of  osteonecrosis  of femoral head were prospectively evaluated with a  mean follow up period of  7.3 years (range from 3 to 12 years). Watson-Jones approach was used in all patients. Average hospital stay was 12 days. Harris hip score was used for the evaluation of clinical outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our series of 27 cases, the Harris hip score was excellent (90-100) in 19, good (80-89) in 5, fair (70-79) in 2 and  poor  (&lt;70) in 1 case at final follow up.</p><p class="Default"><strong>Conclusions:</strong> Tensor fascia lata muscle pedicle grafting is an effective, technically easier, pain relieving head-preserving procedure and will improve outcome in properly selected patients with osteonecrosis of femoral head. </p>

scholarly journals Early results of surgery for femoroacetabular impingement in patients with osteonecrosis of femoral head

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 47
Author(s):  
Tarun Goyal
Keyword(s):  
Femoral Head ◽  
Femoroacetabular Impingement ◽  
Hip Dislocation ◽  
Womac Score ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Osteonecrosis Of Femoral Head ◽  
Hip Impingement ◽  
Cam Deformity ◽  
Early Results

Purpose: Femoroacetabular impingement and its surgical treatment have not been described before in osteonecrosis of femoral head. We present here outcomes of 15 patients with femoroacetabular impingement secondary to osteonecrosis of femoral head. This results from partial collapse of femoral head, particularly in the anterosuperior region, secondary to osteonecrosis. With subsequent remodelling, periphery of the femoral head flattens and osteophytes form in this area. All these patients were managed with open/arthroscopic osteochondroplasty of femoral head. Methods: These patients were symptomatic for hip impingement. Cam deformity was studied using computed tomography and magnetic resonance imaging. In six patients open osteochondroplasty was carried out using surgical hip dislocation. In nine patients arthroscopic femoral head osteochondroplasty was done. All the patients were followed up for hip pain (VAS), Harris hip score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and hip range of motion. Results: A statistically significant improvement in the VAS for pain, HHS, and WOMAC score was noted. Average HHS improved from 71.3 (SD, 13) to 89.7 (SD, 14.5), p-value 0.0079. Average WOMAC improved from 73.6 (SD, 15.4) to 92.4 (SD, 16), p-value 0.0154. Impingement test became negative in all the patients. A significant improvement in hip ROM was noted. There was no conversion to total hip arthroplasty. All patients could sit on the floor cross-legged and squat. Conclusion: Some patients with partial collapse of femoral head due to osteonecrosis present chiefly with symptoms of femoroacetabular impingement. They should be identified as osteochondroplasty gives successful results in these patients. Level of evidence − IV

scholarly journals The Effect of Extracorporeal Shock Wave on Osteonecrosis of Femoral Head: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jin Mei ◽  
Lili Pang ◽  
Yu Gong ◽  
Zhongchao Jiang
Keyword(s):  
Shock Wave ◽  
Femoral Head ◽  
Meta Analysis ◽  
Core Decompression ◽  
Visual Analogue Score ◽  
Harris Hip Score ◽  
Lesion Area ◽  
China National Knowledge Infrastructure ◽  
Osteonecrosis Of Femoral Head ◽  
Extracorporeal Shock Wave

Abstract Background: This study aimed to determine whether ESWT (extracorporeal shock wave therapy) has an efficient effect on ONFH (osteonecrosis of femoral head) in clinical outcomes and radiography outcomes.Method: Two authors independently searched the papers on the treatment of femoral head necrosis with extracorporeal shock wave in CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), CSPD (China Science Periodical Database) , Pubmed, Embase and Springer databases. Search period from the inception dates to June 2, 2020 and have no limitations in language; Two authors independently conducted Quality evaluation and data extraction for included studies and preformed a meta-analysis with data extracted and calculated by using review manager 5.3.Result: Nine articles with 409 patients were included in this meta-analysis. The pooled results of HHS (Harris hip score) in eight studies with 337 hips show that ESWT achieved higher Harris scores compared to before treatment (MD= -19.95;95% CI: -26.27, -13.64;). The differences were statistically significant (p<0.01). The pooled results of VAS (visual analogue score) in seven studies with 253 hips show that ESWT achieved lower VAS compared to baseline (MD= 2.77;95%CI: 1.88, 3.65;), the differences were statistically significant (p<0.01). the pooled results of lesion of MRI with 164 hips show that ESWT decrease the lesion area of MRI (SMD=1.03,CI: 0.75,1.30,),the differences were statistically significant (p<0.01).Conclusion: ESWT have an effect in pain relief and can improve motion function. It's effect better than surgical groups (core decompression and core decompression with bone grafting). But it may not decrease the lesion area of the femoral head on MRI.

scholarly journals Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head

2021 ◽  
Vol 87 (1) ◽  
pp. 25-34
Author(s):  
Sumit Arora ◽  
Manoj Kumar ◽  
Yasim Khan ◽  
Nitish Bansal ◽  
Swati Gupta ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Time Lag ◽  
Harris Hip Score ◽  
Rare Presentation ◽  
Osteonecrosis Of Femoral Head ◽  
Total Hip ◽  
Uncemented Total Hip Arthroplasty

Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. All of them underwent uncemented total hip arthroplasty. All the available publications in the English language based medical literature were critically reviewed and results were summarized. The median age of presentation was 32 years (range : 24 years to 61 years). They were followed up for a mean duration of 25 months (range : 12 months to 59 months). The most common risk factor was corticosteroid consumption (7 out of 10 patients). All except one (modified Ficat and Arlet stage II) belonged to advanced stage of ONFH {stage III 3 patients (3 hips), stage IV 6 patients (8 hips)}. The mean time lag of ONFH to presentation was 22.3 months (range : 5 months to 60 months), and SSF to presentation was 13.8 days (range : 1 day to 28 days). Mean pre- operative Harris Hip Score was 10.8 (range : 8 to 14), which improved to 93 (range : 91 to 96) after total hip arthroplasty when last followed up (p<0.05). Corticosteroids induced ONFH has a propensity to develop SSF. This entity should find a place in existing classification system.

PENERAPAN MODEL QUANTUM LEARNING UNTUK MENINGKATKAN HASIL BELAJAR AUTOCAD SISWA KELAS X TEKNIK PEMESINAN SMK NEGERI 1 STABAT

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Abdul Hasan Saragih
Keyword(s):  
Positive Response ◽  
Phase 1 ◽  
First Grade ◽  
Learning Model ◽  
Second Phase ◽  
Phase 2 ◽  
Phase 3 ◽  
The Third ◽  
Third Phase ◽  
Quantum Learning

This classroom research was conducted on the autocad instructions to the first grade of mechinary class of SMK Negeri 1 Stabat aiming at : (1) improving the student’ archievementon autocad instructional to the student of mechinary architecture class of SMK Negeri 1 Stabat, (2) applying Quantum Learning Model to the students of mechinary class of SMK Negeri 1 Stabat, arising the positive response to autocad subject by applying Quantum Learning Model of the students of mechinary class of SMK Negeri 1 Stabat. The result shows that (1) by applying quantum learning model, the students’ achievement improves significantly. The improvement ofthe achievement of the 34 students is very satisfactory; on the first phase, 27 students passed (70.59%), 10 students failed (29.41%). On the second phase 27 students (79.41%) passed and 7 students (20.59%) failed. On the third phase 30 students (88.24%) passed and 4 students (11.76%) failed. The application of quantum learning model in SMK Negeri 1 Stabat proved satisfying. This was visible from the activeness of the students from phase 1 to 3. The activeness average of the students was 74.31% on phase 1,81.35% on phase 2, and 83.63% on phase 3. (3) The application of the quantum learning model on teaching autocad was very positively welcome by the students of mechinary class of SMK Negeri 1 Stabat. On phase 1 the improvement was 81.53% . It improved to 86.15% on phase 3. Therefore, The improvement ofstudent’ response can be categorized good.

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