scholarly journals Results of surgical treatment of aseptic necrosis of the femoral head at early stages

2013 ◽  
Vol 0 (1) ◽  
pp. 5
Author(s):  
Volodymyr Filipenko ◽  
Gennadiy Olinichenko ◽  
Zoya Miteleva ◽  
Nataliya Poletaeva
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Aseptic Necrosis ◽  
Early Stages

scholarly journals COMBINED IMPACTION AUTOPLASTY OF THE FEMORAL HEAD IN THE TREATMENT OF PATIENTS WITH EARLY STAGES OF ASEPTIC NECROSIS

2017 ◽  
Vol 2 (3) ◽  
pp. 39-44
Author(s):  
DS S Kudashev ◽  
SD D Zuev-Ratnikov ◽  
IS S Shorin
Keyword(s):  
Femoral Head ◽  
Pain Syndrome ◽  
Pathological Process ◽  
Diagnostic Methods ◽  
New Method ◽  
Harris Hip Score ◽  
Aseptic Necrosis ◽  
Early Stages ◽  
Functional Capabilities ◽  
Results Of Treatment

Aseptic necrosis of the femoral head refers to the number of severe, rapidly progressing destructive-dystrophic hip joint lesions. In the overwhelming majority of cases, the disease develops in young and most active age group. In the absence of necessary treatment, the result of the disease is the early disability retirement with the need for radical reconstructive interventions on the joint. The use of modern diagnostic methods makes it possible to detect the beginning of the pathological process in the femoral head in the early stages and to conduct the most effective treatment of patients of this category. Aim - to improve the results of treatment of patients with early stages of aseptic necrosis of the femoral head due to the development and introduction into clinical practice of a new method of combined impaction autoplasty of the femoral head. Materials and methods. A new method of combined impaction autoplasty of the femoral head was used, including decompression, intraosseous resection and excision of the focus of osteonecrosis followed by combined autoplasty of the postresection defect (RF patent No. 2583577 dated 13.04.2016). Intraosseous resection of the focus of destruction of the femoral head was performed with the help of a specially developed device - milling cutters for bone tissue resection (RF patent for utility model No. 171951 dated 21.06.2017). Evaluation of the effectiveness of the treatment was carried out on the basis of the severity of the pain syndrome and functional capabilities of patients defined by the Harris scale (Harris Hip Score). Results. The analysis of the medium-term results of the conducted treatment showed that good results were obtained in 67.4% of cases in which the proposed method was used.

scholarly journals Problems of diagnosis and treatment of aseptic necrosis of the femoral head in contemporary traumatology and orthopedics (literature review)

2021 ◽  
Vol 27 (2) ◽  
pp. 270-276
Author(s):  
D.I. Odarchenko ◽  
◽  
G.G. Dzyuba ◽  
S.A. Erofeev ◽  
N.K. Kuznetsov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Femoral Head ◽  
Literature Review ◽  
Randomized Clinical Trials ◽  
Core Decompression ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Aseptic Necrosis ◽  
Early Stages

administration of corticosteroids or blood diseases. Early diagnosis is difficult, there is no conservative treatment protocol with proven effectiveness, and the organ-preserving surgical treatments which have been used may not always postpone hip arthroplasty. Arthroplasty provides good results in the short and long-term postoperative period, but the prevalence of this disease among young people requires developing new methods of conservative and operative treatment. Objective To determine the problems of diagnosis and treatment of aseptic necrosis of the femoral head; to study the experience of current approaches and concepts in the diagnosis and treatment of ANFH; determine the range of the most effective methods for treating this pathology; to establish the relevance of further research on this issue. Materials and methods Literature review was conducted of the sources from PubMed and Google Scholar databases. The material was selected that corresponded to the stated purpose of the research topic. For describing some aspects of the aetiology, pathogenesis and development of methods for diagnosing and treating ANFH, earlier publications (2009–2014) were also used. Results The main views on the aetiology and pathogenesis of ANFH have been studied. Classical and current diagnostic methods for ANFH were reviewed as well as current operative and conservative approaches to the treatment of this pathology. A review of the main classifications was conducted. Discussion Early detection and examination of at-risk patients plays an important role in the diagnosis of ANFH. The results of clinical trials on the use of bisphosphonates seem mixed, as the meta-analysis in five randomized clinical trials (RCTs) in 2016 showed no statistically significant improvement in patients with ANFH. Hyperbaric oxygenation reduces interstitial ischemia by increasing extracellular oxygen concentration and shows encouraging results. Core decompression is recognized as the standard care in the early stages of ANFH. At present, the use of combined treatment with bisphosphonates, core-decompression and mesenchymal stem cells has been investigated. Combined therapy may be effective in slowing the progression of collapse at an early stage of ANFH, but further research is needed to have long-term results. Conclusion Aseptic necrosis of the femoral head is a severe polyetiological disease that has not been sufficiently studied. For its diagnosis, it is necessary to take into account the possible risk factors and to ensure an early MRI study. At present, there is no data on a conservative method of treating the early stages of ANFH, which would have high evidence and effectiveness not only in the immediate, but also in the long-term follow-up. It is necessary to conduct additional prospective randomized clinical trials to determine the effectiveness of already known and developed methods of cell therapy in the treatment of ANFH.

Potentialities of Surgical Treatment for Acetabular Fractures Using Low-Invasive Techniques

2009 ◽  
Vol 16 (2) ◽  
pp. 3-9
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
A A Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Invasive Surgery ◽  
Surgical Approach ◽  
Acetabular Fractures ◽  
Aseptic Necrosis ◽  
Social Rehabilitation ◽  
Bone Fragments ◽  
Invasive Techniques ◽  
Percutaneous Osteosynthesis

Original technique of percutaneous osteosynthesis was applied for the treatment of 24 patients with acetabular columns fractures. The achieved results were compared to the results of osteosynthesis performed using open direct reposition of bone fragments (39 patients). The efficacy of low-invasive surgery in acetabular column fractures with regard to provision of fragments consolidation, prevention of femoral head aseptic necrosis development and achievement of early medical and social rehabilitation of patients was showed. Maintenance of fragments blood supply, use of minimal surgical approach and closed reposition are considered to be the progressive direction of internal osteosynthesis development.

scholarly journals THE CONSERVATIVE SURGICAL TREATMENT OF IDIOPATHIC ASEPTIC NECROSIS OF THE FEMORAL HEAD

1974 ◽  
Vol 56-B (2) ◽  
pp. 291-296 ◽  
Author(s):  
M. Kerboul ◽  
J. Thomine ◽  
M. Postel ◽  
R. Merle D'Aubigné
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Aseptic Necrosis

scholarly journals Complications of Acute Acetabular Fractures Surgical Treatment: Systematic Review

2021 ◽  
Vol 27 (2) ◽  
pp. 144-155
Author(s):  
A. I. Kolesnik ◽  
N. V. Zagorodniy ◽  
A. A. Ochkurenko ◽  
A. F. Lazarev ◽  
E. I. Solod ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Femoral Head ◽  
Sciatic Nerve ◽  
Intraoperative Complications ◽  
Surgical Approaches ◽  
Acetabular Fractures ◽  
Aseptic Necrosis ◽  
Superior Gluteal Artery ◽  
Duration Of Surgery

Background.The combination of classical anterior and posterior approaches, as well as their modifications, is recognized as the most effective in acetabular fractures surgical treatment. The use of classical and modified approaches is accompanied by  serious  intra-  and  postoperative  complications  associated  primarily  with  the  duration  of  surgery,  significant  blood loss, tissue trauma, surgical site infection. The aim of review — to determine the main and most frequent complications associated with surgical approaches to the acetabulum. material and methods. Access to literature sources is carried out in the information systems and databases PubMed/Medline, Embase, Scopus, Сochran Library, eLibrary, Wiley Online Library. Keywords: acetabular fractures, surgical treatment, approach to the acetabulum, total hip replacement.Results. The most common intraoperative complications are incorrect fragments reduction, sciatic nerve injury, less often — intraarticular implant position, damage to the superior gluteal artery and other vessels, among the early postoperative complications - wound infection, both superficial and deep, less often — venous thrombosis. Late postoperative complications are mainly represented  by  the  development  of  heterotopic  ossification,  post-traumatic  coxarthrosis,  less  often  revealed  aseptic necrosis of the femoral head, residual protrusion and secondary femoral head lesion. Conclusion. The main approach to the acetabulum are the ileo-inguinal and the Kocher-Langenbeck approach, as well as their combination.Complications were more common using two approaches, especially in cases of simultaneous use. The main intraoperative complications are the sciatic nerve and the superior gluteal artery injury with posterior approaches, the femoral lateral cutaneous nerve with expanded ilio-femoral approach, and the obturator nerve with anterior approaches.

scholarly journals Surgical treatment of the femoral head aseptic necrosis in children

2015 ◽  
pp. 17-20
Author(s):  
A.M. Dzhuraev ◽  
◽  
Kh.R. Rakhmatullaev ◽  
R.Kh. Tilavov ◽  
K.N. Valieva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Aseptic Necrosis

Drilling and plombage (core decompression) of a femoral head avascular necrosis

2010 ◽  
Vol 19 (01) ◽  
pp. 36-39 ◽  
Author(s):  
P. Chládek ◽  
V. Havlas ◽  
T. Trc
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Core Decompression ◽  
Effective Treatment Option ◽  
Simple Method ◽  
X Ray ◽  
Large Femoral Head ◽  
Press Fit ◽  
Round Shape ◽  
Late Stages

SummaryThe treatment of femoral head necrosis of adults is still rather problematic. Conservative treatment has been reported relatively unsuccessful and surgical treatment does not show convincing results either. The most effective seems to be a surgical treatment in early stages of the disease, however, the diagnosis still remains relatively complicated. For the late stages (2B and above) the most effective treatment option is represented by core decompression and vascular grafting. However, drilling and plombage (especially when using press-fit technique) seems to be successful, although not excellent. The authors describe their own method of drilling and plombage of the necrotic zone of the femoral head in 41 patients with X-ray detected necrotic changes of the femoral head. The pain measured by VAS was seen to decrease after surgery in all patients significantly. The Jacobs score was also observed to have increased (from fair to good outcome). We have not observed any large femoral head collapse after surgery, moreover, in some cases an improvement of the round shape of the femoral head was seen. It is important to mention that in all cases femoral heads with existing necrotic changes (flattening or collapse) were treated. Although the clinical improvement after surgery was not significantly high, the method we describe is a safe and simple method of diminishing pain in attempt to prepare the femoral head for further treatment in a future, without significant restriction of the indication due to necrosis (osteochondroplasty, resurfacing, THR).

Functional state of neuromotor apparatus and microvasculature in patients with femoral head aseptic necrosis

2019 ◽  
Vol 17 (6 (part 2)) ◽  
pp. 53-59
Author(s):  
A. M. Eremeev ◽  
◽  
A. A. Shulman ◽  
I. F. Akhtyamov ◽  
I. I. Shaykhutdinov ◽  
...  
Keyword(s):  
Femoral Head ◽  
Functional State ◽  
Aseptic Necrosis ◽  
Neuromotor Apparatus

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.

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