scholarly journals Treatment of pre-collapse non-traumatic osteonecrosis of the femoral head through Orthopdische Chirurgie München approach combined with autologous bone mixed with β-tricalcium phosphate porous bioceramic bone graft: a retrospective study of mid-term results

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Dawei Liang ◽  
Jia Pei ◽  
Leilei Zhang ◽  
Haonan Ling ◽  
Youwen Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Bone Graft ◽  
Head And Neck ◽  
Tricalcium Phosphate ◽  
Risk Model ◽  
Clinical Failure ◽  
Multivariate Risk ◽  
Porous Bioceramic ◽  
Autologous Bone

Abstract Background This study aimed to evaluate the clinical efficacy of femoral head and neck fenestration combined with autologous bone mixed with β-tricalcium phosphate porous bioceramic bone (light bulb procedure) through Orthopdische Chirurgie München approach (OCM approach) for pre-collapse non-traumatic osteonecrosis of the femoral head(ONFH). Methods The clinical data of 47 patients (47 hips) with ONFH were retrospectively reviewed. The Harris hip score (HHS) was used to evaluate the clinical outcomes. Imaging was assessed by X-ray. Clinical failure was defined as postoperative total hip arthroplasty (THA) or the HHS was poor (< 70). The Kaplan–Meier survival curve was used to conduct a univariate analysis of risk factors. The analysis factors included gender, age, International Association Research Circulation Osseous (ARCO) stage, etiology, body mass index (BMI), 25-hydroxyvitamin D (25(OH)D), and type I collagen carboxy-terminal peptide (CTX). The COX multivariate risk model was used to analyze the risk factors. Results All the 47 hips were followed up for 24–58 months, with an average of 45 months. The Harris score (76.29 ± 10.38) at the last follow-up was significantly higher than the preoperative HHS (64.45 ± 2.93) (P < 0.05). The postoperative HHS was excellent with a success rate of 36.17%. Postoperative imaging evaluation showed that 9 hips improved, 28 hips stabilized, and 10 hips progressed. Moreover, 17 out of 47 hips were defined as a postoperative clinical failure and the success rate was 63.83%. 25(OH)D and preoperative ARCO stage were risk factors for postoperative clinical failure (P < 0.05). The COX multivariate risk model analysis showed that IIIA stage was an independent risk factor for postoperative clinical failure (P < 0.05). Conclusions The head and neck fenestration and bone grafting via the OCM approach in the treatment of non-traumatic ONFH in the pre-collapse stage can achieve good clinical outcomes. 25(OH)D deficient patients and ARCO IIIA patients had a higher failure rate of bone graft using this approach.

Clinical Efficacy of the Orthopdische Chirurgie München Approach With Bone Grafting for Pre-Collapse Non-Traumatic Osteonecrosis of the Femoral Head: A Retrospective Study

2021 ◽  
Author(s):  
Dawei Liang ◽  
Jia Pei ◽  
Leilei Zhang ◽  
Haonan Ling ◽  
Youwen Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Success Rate ◽  
Clinical Outcomes ◽  
Clinical Efficacy ◽  
Bone Grafting ◽  
Risk Model ◽  
Harris Hip Score ◽  
Clinical Failure ◽  
Multivariate Risk

Abstract BackgroundThis study aimed to evaluate the clinical efficacy of autologous bone mixed with tricalcium phosphate porous bioceramic bone grafting via Orthopdische Chirurgie München approach (OCM approach) with fenestration of the femoral head-neck in patients with pre-collapse non-traumatic osteonecrosis of the femoral head (ONFH).MethodsThe clinical data of 47 patients (47 hips) with ONFH were retrospectively reviewed. The Harris hip score (HHS) was used to evaluate the clinical outcomes. Imaging was assessed by X-ray. Clinical failure was defined as postoperative total hip arthroplasty (THA) or the HHS was poor (<70). The Kaplan-Meier survival curve was used to conduct a univariate analysis of risk factors. The analysis factors included gender, age, International Association Research Circulation Osseous (ARCO) stage, etiology, body mass index (BMI), and 25-hydroxyvitamin D (25(OH)D). The COX multivariate risk model was used to analyze the risk factors.ResultsAll the 47 hips were followed up for 24-58 months, with an average of 45 months. The Harris score (76.29 ± 10.38) at the last follow-up was significantly higher than the preoperative HHS (64.45 ± 2.93) (P<0.05). The postoperative HHS was excellent with a success rate of 36.17%. Postoperative imaging evaluation showed that 9 hips improved, 28 hips stabilized, and 10 hips progressed. Moreover, 17 out of 47 hips were defined as a postoperative clinical failure and the success rate was 63.83%. 25(OH)D and preoperative ARCO stage were risk factors for postoperative clinical failure (P<0.05). The COX multivariate risk model analysis showed that ⅢA stage was an independent risk factor for postoperative clinical failure (P<0.05).ConclusionsThe head and neck fenestration and bone grafting via the OCM approach in the treatment of non-traumatic ONFH in the pre-collapse stage can achieve good clinical outcomes. 25(OH)D deficient patients and ARCO IIIA patients had a higher failure rate of bone graft using this approach.

scholarly journals Pain relief with core decompression and autologous bone graft in osteonecrosis of femoral head in grade 2

2019 ◽  
Vol 5 (4) ◽  
pp. 369-372
Author(s):  
Dr. Dhruv Sharma ◽  
Dr. Maulik Jhaveri ◽  
Dr. Urang Patel ◽  
Dr. Amrit Jha ◽  
Dr. Prasanna Shah ◽  
...  
Keyword(s):  
Pain Relief ◽  
Femoral Head ◽  
Bone Graft ◽  
Core Decompression ◽  
Autologous Bone Graft ◽  
Osteonecrosis Of Femoral Head ◽  
Autologous Bone

scholarly journals Treatment of Monolateral Legg-Calvé-Perthes Disease with Autologous Bone Marrow Mononuclear Cells in 32 Dogs

VCOT Open ◽  
2020 ◽  
Vol 03 (01) ◽  
pp. e1-e10 ◽  
Author(s):  
Alberto Maria Crovace ◽  
Luca Lacitignola ◽  
Francesco Staffieri ◽  
Edda Francioso ◽  
Giacomo Rossi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Minimally Invasive ◽  
Head And Neck ◽  
Mononuclear Cells ◽  
Autologous Bone Marrow ◽  
Bone Marrow Mononuclear Cells ◽  
Invasive Treatment ◽  
The Mean ◽  
Autologous Bone

Abstract Objective In the present study, we report our results of the use of autologous bone marrow mononuclear cells (BMMCs) as a minimally invasive treatment for Legg-Calvé-Perthes in dogs. Study Design In accordance with Ljunggren's scale, inclusion criteria were determined by clinical condition and radiographic features of the disease, resulting in 32 dogs enrolled in this retrospective study from 2007 to 2019. Bone marrow was collected from each dog from the iliac crest and the mononuclear fraction was separated with density gradient centrifugation. The mean number of BMMCs was 104.7 ± 46.5 × 106 cells. The mean BMMC colony-forming units were 71.6 ± 51.9 × 102/mL.Cells were suspended in fibrin glue before BMMC administration and implanted via transcutaneous injection under computed tomography or radiographic guidance, using a Jamshidi needle inserted through the femoral head and neck. Results A progressive reduction of pain within 3 weeks after BMMC administration was observed in 28 patients, with gradually increased weight bearing on the affected limb. In four dogs, however, pain and lameness persisted and at 3 months post-BMMC injection, femoral head and neck resection was performed. Histological and immunohistochemical studies were done on samples from those four dogs, which showed evidence of formation of new cartilage and subchondral bone in the area where cells were implanted. Clinical Significance Based on these results, BMMC therapy may be considered as effective and minimally invasive treatment option for LCPD in dogs.

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