Application of Erythropoietin and Iron in Total Hip Arthroplasty of Hormonal Osteonecrosis of Femoral Head

2021 ◽  
Vol 11 (04) ◽  
pp. 1214-1221
Author(s):  
春辉 赵
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Osteonecrosis Of Femoral Head ◽  
Total Hip

scholarly journals Short term outcome of primary un-cemented total hip arthroplasty in osteonecrosis of femoral head

2021 ◽  
Vol 7 (3) ◽  
pp. 513
Author(s):  
Mohmad Nawaz Rather ◽  
Wajahat Ahmad Mir ◽  
Shahid Shabir Khan ◽  
Naseer Ahmad Mir ◽  
Nadeem Ali
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Short Term ◽  
Range Of Movement ◽  
Term Outcome ◽  
Osteonecrosis Of Femoral Head ◽  
Total Hip ◽  
Uncemented Total Hip Arthroplasty ◽  
Advanced Stages

<p class="abstract"><strong>Background:</strong> Osteonecrosis of femoral head (ONFH) is characterised by cell death in the subchondral bone caused by abnormalities of blood flow to the femoral head. About 5% to 13% of arthroplasties are performed yearly for ONFH in United States. Ficat and Arlet classification is the commonest system used for grading of ONFH. Advanced stages 3 and 4 are best managed with total hip arthroplasty (THA). THA restores hip range of movement and allows early ambulation in ONFH.</p><p class="abstract"><strong>Methods:</strong> After seeking approval from local institutional ethical committee 25 patients with stage 3 and stage 4 ONFH (Ficat and Arlet) were admitted from OPD of SKIMS MC and Hospital Bemina, Srinagar. The study was conducted from February 2018 to February 2020 in department of Orthopaedics SKIMS MC and Hospital Bemina, Srinagar.  25 patients with mean age of 50.64 years comprising of 13 females and 12 males with unilateral osteonecrosis of femoral head with collapsed head underwent uncemented total hip arthroplasty and were followed up to a minimum of 1 year post-operatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Outcome was evaluated by comparing pre-operative and post-operative Harris hip scores. The average Harris hip scores improved from 65.87 in the pre-operative group to 96.54 at 1-year follow-up post-operatively. Marked improvement was noted in pain scores. No revisions were performed during the study. One patient developed superficial surgical site infection which healed with supervised dressings and oral antibiotics.</p><p class="abstract"><strong>Conclusions:</strong> Uncemented THA has excellent short-term outcomes in advanced stages of ONFH. It provides mobile hip joint and pain free ambulation shortly after surgery.</p>

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.

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

scholarly journals A Novel Measurement Using Digital Radiography to Minimize Fluoroscopy in Total Hip Arthroplasty

2021 ◽  
Author(s):  
Andrew G. Yun ◽  
Marilena Qutami ◽  
Kory B. Dylan Pasko
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Radiation Exposure ◽  
Hip Arthroplasty ◽  
Fluoroscopy Time ◽  
Lesser Trochanter ◽  
Total Hip ◽  
Preoperative Templating ◽  
The Mean ◽  
Templating Technique

AbstractPreoperative templating for total hip arthroplasty (THA) is fraught with uncertainty. Specifically, the conventional measurement of the lesser trochanter to the center (LTC) of the femoral head used in preoperative planning is easily measured on a template but not measurable intraoperatively. The purpose of this study was to examine the utility of a novel measurement that is reproducible both on templating and in surgery as a more accurate and practical guide. We retrospectively reviewed 201 patients with a history of osteoarthritis who underwent primary THA. For preoperative templating, the distance from the top of the lesser trochanter to the equator (LeTE) of the femoral head was measured on a calibrated digital radiograph with a neutral pelvis. This measurement was used intraoperatively to guide the choice of the trial neck and head. As with any templating technique, the goal was to construct a stable, impingement-free THA with equivalent leg lengths and hip offset. In evaluating this novel templating technique, the primary outcomes measured were the number of trial reductions and the amount of fluoroscopic time, exposures, and radiation required to obtain a balanced THA reconstruction. Using the LeTE measurement, the mean number of trial reductions was 1.21, the mean number of intraoperative fluoroscopy images taken was 2.63, the mean dose of radiation exposure from fluoroscopy was 0.02 mGy, and the mean fluoroscopy time per procedure was 0.6 seconds. In hips templated with the conventional LTC prior to the LeTE, the mean fluoroscopy time was 0.9 seconds. There was a statistically significant difference in fluoroscopy time (p < 0.001). The LeTE is a reproducible measurement that transfers reliably from digital templating to surgery. This novel preoperative templating metric reduces the fluoroscopy time and consequent radiation exposure to the surgical team and may minimize the number of trial reductions.

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