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 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 Early results of cementless hip arthroplasty in the treatment of femoral head posttraumatic and atraumatic osteonecrosis

2005 ◽  
Vol 62 (7-8) ◽  
pp. 513-517
Author(s):  
Dragan Jeremic ◽  
Dragan Nikolic ◽  
Srbislav Ilic ◽  
Vlajko Draskovic
Keyword(s):  
Femoral Head ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Sciatic Nerve Palsy ◽  
Military Medical Academy ◽  
Cementless Hip Arthroplasty ◽  
Early Results ◽  
Medical Academy ◽  
Significant Difference ◽  
Student’S T

Aim. To evaluate the value of cementless hip arthroplasty in the treatment of posttraumatic and atraumatic osteonecrosis (ON) of the femoral head. Methods. The study was conducted at the Department of Orthopedics and Traumatology, Military Medical Academy, between January 1st, 1999 and December 31st, 2003. Twenty five patients with 27 implanted endoprostheses, and the diagnosis of osteonecrosis of the femoral head, and radiographically confirmed Arlet-Ficat stage III and IV were evaluated retrospectively. The results were evaluated according to Harris Hip Score (HHS). The research included 10 patients with traumatically induced osteonecrosis and 15 patients (17 endoprothesis) with osteonecrosis of the femoral head. The mean age of the patients in the group with posttraumatic osteonecrosis of the femoral head was 41 (19-62) years, and in the group of the patients with atraumatic osteonecrosis of the femoral head it was 40.2 (21-53) years. Complications included one case with postoperative luxation, and one case with iatrogenic sciatic nerve palsy. Results. The average Harris Hip Scores in the group of posttraumatic osteonecrosis were 31 points preoperatively and 86 points postoperatively. In the group of osteonecrosis of atraumatic etiology, the average Harris Hip Score was 28 points preoperatively, and 77 points postoperatively. Postoperative Harris Hip Scores were compared with the Student's t-test and the results showed no statistically significant difference (p = 0,125). Conclusions. Our study did not find any significant difference between the results of posttraumatic and atraumatic osteonecrosis of the femoral head treated with cementless endoprosthesis.

scholarly journals Serum CXCL12/SDF-1 level is positively related with lumbar intervertebral disc degeneration and clinical severity

2019 ◽  
Vol 26 (5) ◽  
pp. 341-350
Author(s):  
Zhao-Juan Er ◽  
Chun-Fang Yin ◽  
Wen-Jing Wang ◽  
Xue-Jun Chen
Keyword(s):  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Roc Curve ◽  
Intervertebral Disc Degeneration ◽  
Curve Analysis ◽  
Clinical Severity ◽  
Roc Curve Analysis ◽  
Lumbar Intervertebral Disc ◽  
Tnf Α ◽  
Pfirrmann Grade

This study aimed to examine whether stromal cell-derived factor-1 (SDF-1) or C-X-C chemokine ligand 12 (CXCL12) participates in the development of lumbar disc degeneration, as implicated earlier by the level of CXCL12 correlating with this disease. It enrolled 145 patients with symptomatic lumbar intervertebral disc degeneration (IDD) and 130 asymptomatic healthy controls with no indication of IDD. Radiological assessment of the IDD patients was targeted at the lumbar vertebra region, based on Pfirrmann grade. Degeneration of the multifidus and psoas major muscles was evaluated using Goutallier classification. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were obtained for assessing the severity of manifestation. The levels of serum CXCL12, IL-6 and TNF-α were determined by ROC curve analysis, resulting in their prognostic value for Pfirrmann grading. Higher levels of serum CXCL12 were found in patients with IDD than in asymptomatic individuals, and were positively related to the Pfirrmann grade as well as multifidus muscle degeneration. Furthermore, serum CXCL12 concentration showed a significant correlation with the VAS and ODI scores. In addition, elevated serum CXCL12 levels were related to serum levels of TNF-α and IL-6. The ROC curve analysis implicated that CXCL12 could function as a biomarker of the early-mediate phase of IDD development. In summary, the serum CXCL12/SDF-1 level is positively related with lumbar IDD and its clinical severity.

scholarly journals Distinguishable Immunologic Characteristics of COVID-19 Patients with Comorbid Type 2 Diabetes Compared with Nondiabetic Individuals

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ruxing Zhao ◽  
Yujing Sun ◽  
Yongyuan Zhang ◽  
Weili Wang ◽  
Shouyu Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Immunological Response ◽  
Clinical Severity ◽  
Blood Levels ◽  
Immunological Parameters ◽  
Global Pandemic ◽  
Tnf Α ◽  
Significant Difference ◽  
Ifn Γ

Background. COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has threatened every civilian as a global pandemic. The immune system poses the critical interactive chain between the human body and the virus. Here, we make efforts to examine whether comorbidity with type 2 diabetes (T2D) affects the immunological response in COVID-19 patients. Methods. We conducted a retrospective pilot study investigating immunological characteristics of confirmed cases of COVID-19 with or without comorbid T2D. Two subcohorts of sex- and age-matched participants were eligible for data analysis, of which 33 participants were with T2D and the remaining 37 were nondiabetic (NDM). Cellular immunity was assessed by flow cytometric determination of surface markers including CD3, CD4, CD8, CD19, CD16, and CD56 in peripheral blood. Levels of C reactive protein, immunoglobulin (IgG, IgM, IgA, and IgE), and complements (C3, C4) were detected by rate nephelometry immunoassay. And Th1/Th2 cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were detected by Cytometric Bead Array. Results. Neutrophil counts were found to be significantly higher in the T2D group than in the NDM group and had a significant relevance with clinical severity. Lymphocyte frequencies showed no significant differences in the two groups. However, the proportions and absolute counts of T, Tc, Th, and NK cells decreased in both groups to different degrees. An abnormal increase in neutrophil count and a decrease in lymphocyte subpopulations may represent risk factors of COVID-19 severity. The level of IgG, IgM, IgA, C3, and C4 showed no significant difference between the two groups, while the IgE levels were higher in the T2D group than in the NDM group ( p < 0.05 ). Th1 cytokines including IFN-γ, TNF-α, and IL-6, as well as CRP, appeared significantly higher in the T2D group. Conclusions. The COVID-19 patients comorbid with T2D demonstrated distinguishable immunological parameters, which represented clinical relevancies with the predisposed disease severity in T2D.

scholarly journals The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Kun-chi Hua ◽  
Xiong-gang Yang ◽  
Jiang-tao Feng ◽  
Feng Wang ◽  
Li Yang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Radiographic Progression ◽  
Meta Analysis ◽  
Core Decompression ◽  
Femoral Head Necrosis ◽  
Significant Difference ◽  
Autologous Bone ◽  
Necrosis Of Femoral Head ◽  
Rate Of Success

Abstract Background Core decompression (CD) is an important method for the treatment of osteonecrosis of the femoral head (ONFH). Few articles investigate the influence of core decompression on outcomes of ONFH. This study was carried out to observe the safety and effectiveness of core decompression in the treatment of ONFH. Methods A comprehensive literature search of databases including PubMed, Embase, and Cochrane Library was performed to collect the related studies. The medical subject headings used were “femur head necrosis” and “Core decompression.” The relevant words in title or abstract included but not limited to “Osteonecrosis of the Femoral Head,” “femoral head necrosis,” “avascular necrosis of femoral head,” and “ischemic necrosis of femoral head.” The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Results Thirty-two studies included 1865 patients (2441 hips). Twenty-one studies (1301 hips) using Ficat staging standard, 7 studies (338hips) using Association Research Circulation Osseous (ARCO) staging standard, and University of Pennsylvania system for staging avascular necrosis (UPSS) staging criteria for 4 studies (802 hips). All the studies recorded the treatment, 22 studies (1379 hips) were treated with core decompression (CD) alone, and 7 studies (565 hips) were treated with core decompression combined with autologous bone (CD Autologous bone). Nine subjects (497 hips) were treated with core decompression combined with autologous bone marrow (CD Marrow). Twenty-seven studies (2120 hips) documented the number of conversion to total hip replacement (THA), and 26 studies (1752hips) documented the number of radiographic progression (RP). Twenty-one studies recorded the types of complications and the number of cases, a total of 69 cases. The random-effect model was used for meta-analysis, and the results showed that the overall success rate was 65%. The rate of success showed significant difference on the outcomes of different stages. The rate of success, conversion to THA, and radiographic progression showed significant difference on the outcomes of ONFH using different treatments. Conclusions Core decompression is an effective and safe method of treating ONFH. The combined use of autologous bone or bone marrow can increase the success rate. For advanced femoral head necrosis, the use of CD should be cautious. High-quality randomized controlled trials and prospective studies will be necessary to clarify the effects of different etiology factors, treatments, and postoperative rehabilitation. Until then, the surgeon can choose core decompression to treat ONFH depending on the patient’s condition. Level of evidence I Meta-analysis

scholarly journals The effect of tumour necrosis factor inhibitors on radiographic progression in axial spondyloarthritis: a systematic literature review

Rheumatology ◽  
2019 ◽  
Vol 58 (11) ◽  
pp. 1907-1922 ◽  
Author(s):  
Nadine Boers ◽  
Celia A J Michielsens ◽  
Désirée van der Heijde ◽  
Alfons A den Broeder ◽  
Paco M J Welsing
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Radiographic Progression ◽  
Axial Spondyloarthritis ◽  
Standard Dose ◽  
Tnf Α ◽  
Significant Difference ◽  
Synthetic Dmards ◽  
Necrosis Factor

Abstract The effect of TNF-α inhibitors (TNFi), with or without concomitant NSAIDs, on radiographic progression in axial SpA remains unclear. Therefore, we performed a systematic literature review up to January 2019 to determine whether longer use of standard dose TNFi is superior vs lower duration or lower dose TNFi therapy, conventional synthetic DMARDs alone, or no therapy in inhibiting radiographic progression in patients with axial SpA. Our search yielded 373 titles of which 14 full text articles and five abstracts were eligible for quantitative analysis. Studies had an overall moderate to critical risk of bias. Data could not be pooled due to clinical and methodological heterogeneity. Individual studies showed conflicting results with mainly no significant difference in radiographic progression when comparing effect of TNFi therapy to no TNFi therapy or when comparing to less TNFi therapy until 2 years of follow-up. Results that are more significant are shown after 2 years’ follow-up, mainly in subgroups with baseline syndesmophytes. Data on the additional or synergistic effect of concomitant NSAID use were inconclusive.

scholarly journals Elevated plasma CXCL12/SDF-1 levels are linked with disease severity of postmenopausal osteoporosis

2019 ◽  
Vol 26 (3) ◽  
pp. 222-230 ◽  
Author(s):  
Xian-Wen Yang ◽  
Hong-Xing Huang ◽  
Fei Wang ◽  
Qi-Lin Zhou ◽  
Yan-Qiang Huang ◽  
...  
Keyword(s):  
Postmenopausal Osteoporosis ◽  
Disease Severity ◽  
Clinical Severity ◽  
Elevated Plasma ◽  
Mineral Density ◽  
Tnf Α ◽  
Hip Bmd ◽  
Grading Scale ◽  
Collagen Type 1

This study was designed to determine whether plasma CXCL12 levels in postmenopausal osteoporosis (PMOP) patients are related to disease severity. A total of 91 PMOP females were recruited, and 88 postmenopausal non-osteoporotic (PMNOP) women and 90 healthy females were incorporated as controls. Dual-energy X-ray absorptiometry was utilised to explore bone-mineral density (BMD). The Genant semi-quantitative grading scale was used for vertebral fractures, and plasma CXCL12/SDF-1 levels were investigated by ELISA. Plasma TNF-α and C-telopeptide cross-linked collagen type 1 (CTX-1) were also tested. The Oswestry Disability Index (ODI) and a visual analogue scale (VAS) were completed in order to assess clinical severity. Plasma CXCL12 levels were considerably elevated in PMOP females compared to PMNOP women and healthy controls. Plasma CXCL12 concentrations were positively correlated with the Genant grading system. We observed significant and negative correlations of plasma CXCL12 levels with lumbar spine, femoral neck and total hip BMD. Moreover, plasma CXCL12 concentrations were positively correlated to VAS and ODI, as well as plasma TNF-α and CTX-1 levels. In conclusion, elevated plasma CXCL12 levels are correlated with disease severity in PMOP females.

scholarly journals Osteonecrosis of the hip: is there a difference in the survivorship of total hip arthroplasty with or without previous vascular iliac bone grafting?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wai-Wang Chau ◽  
Jonathan Patrick Ng ◽  
Hiu-Woo Lau ◽  
Michael Tim-Yun Ong ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Iliac Bone ◽  
Harris Hip Score ◽  
Implant Survival ◽  
Total Hip ◽  
Implant Survivorship ◽  
Significant Difference

Abstract Background Osteonecrosis of the femoral head (ONFH) is a debilitating condition. Vascularized iliac bone graft (VIBG) is a joint-preserving surgery to improve blood supply to the avascular portion of the femoral head which may delay secondary osteoarthritis and total hip arthroplasty (THA). However, whether VIBG will affect the subsequent THA survivorship and outcomes are still uncertain. Methods Implant survivorship and clinical outcomes were compared between 27 patients who had undergone prior VIBG and 242 patients who had only undergone THA for ONFH. Baseline characteristics and the postoperative Harris Hip Score (HHS) were also recorded and compared between the two groups. Implant survivorship was determined using Kaplan-Meier survival analysis. Results The overall implant survival for all patients who had a primary diagnosis of ONFH and eventually underwent THA was 92.9%. There was no significant difference in the implant survivorship between the group who directly received THA (survivorship of 93%) and the group which failed VIBG and was subsequently converted to THA (survivorship of 91.9%) (p = 0.71). In addition, higher THA revision rates were associated with smokers and drinkers. Conclusions VIBG may be a reasonable option as a “buy-time” procedure for ONFH. Even if conversion to THA is eventually required, patients may be reassured that the overall survivorship and clinical outcomes may not be compromised. Patients are recommended to give up smoking and binge drinking prior to THA to increase implant survival rate.

scholarly journals Core decompression and autologous bone marrow concentrate for treatment of femoral head osteonecrosis: a randomized prospective study

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Wojciech Pepke ◽  
Philip Kasten ◽  
Nicholas Beckmann ◽  
Patricia Janicki ◽  
Marcus Egermann
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Clinical Outcome ◽  
Core Decompression ◽  
Harris Hip Score ◽  
Bone Marrow Concentrate ◽  
Functional Benefit ◽  
Femoral Head Osteonecrosis ◽  
Significant Difference

The aim of this study was to investigate the safety of injection of bone marrow aspirate concentrate during core decompression and to study its clinical (visual analogue scale; Harris-Hip-score) and radiological outcomes (magnetic resonance imaging). In this prospective and randomized clinical trial we evaluated 24 consecutive patients with nontraumatic femoral head necrosis (FHN) during a period of two years after intervention. In vitro analysis of mesenchymal stem cells was performed by evaluating the fibroblast colony forming units (CFU-Fs). Postoperatively, significant decrease in pain associated with a functional benefit lasting was observed. However, there was no difference in the clinical outcome between the two study groups. Over the period of two years there was no significant difference between the head survival rate between both groups. In contrast to that, we could not perceive any significant change in the volume of FHN in both treatment groups related to the longitudinal course after treating. The number of CFU showed a significant increase after centrifugation. This trial could not detect a benefit from the additional injection of bone marrow concentrate with regard to bone regeneration and clinical outcome in the short term.

scholarly journals Osteonecrosis of The Hip: Is There A Difference In The Survivorship Of Total Hip Arthroplasty With or Without Previous Vascular Iliac Bone Grafting

2021 ◽  
Author(s):  
Wai Wang Chau ◽  
Jonathan Patrick Ng ◽  
Hiu-Woo Lau ◽  
Michael Tim-Yun Ong ◽  
Kwong-Yin Chung ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Iliac Bone ◽  
Harris Hip Score ◽  
Implant Survival ◽  
Total Hip ◽  
Implant Survivorship ◽  
Significant Difference

Abstract BackgroundOsteonecrosis of the femoral head (ONFH) is a debilitating condition. Vascularized iliac bone grafts (VIBG) is a joint preserving surgery to improve blood supply to the avascular portion of the femoral head which may delay secondary osteoarthritis and total hip arthroplasty (THA). However, whether VIBG will affect the subsequent THA survivorship and outcomes is still uncertain.MethodsImplant survivorship and clinical outcomes were compared between 37 patients who had undergone prior VIBG and 302 patient who had only undergone THA for ONFH. Baseline characteristics and the postoperative Harris Hip Score (HHS) were also recorded and compared between the two groups. Implant survivorship was determined using Kaplan–Meier survival analysis.ResultsThe overall implant survival for all patients who had a primary diagnosis of ONFH and eventually underwent THA was 92.9%. There was no significant difference in the implant survivorship between the group who directly received THA (survivorship of 93%), and the group which failed VIBG and was subsequently converted to THA (survivorship of 91.9%) (p= 0.71). In addition, higher THA revision rates were associated with smokers and drinkers. ConclusionsVIBG may be a reasonable option as a “buy-time” procedure for ONFH. Even if conversion to THA is eventually required, patients may be reassured that the overall survivorship and clinical outcomes may not be compromised. Patients are recommended to give up smoking and binge drinking before THA to increase the implant survival rate.

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