scholarly journals Clinical study on the Minimally Invasive Treatment of Early Necrosis of the Femoral Head with Hydroxyapatite Coated Hollow Titanium Rod Supporting the Femoral Head to Prevent Collapse

2021 ◽  
Author(s):  
Xinmin Yang ◽  
Ye Tian ◽  
Yao Yao
Keyword(s):  
Femoral Head ◽  
Minimally Invasive ◽  
Articular Surface ◽  
Onset Time ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Improvement Rate ◽  
Significant Difference ◽  
Harris Score

Abstract Background: To investigate the treatment effect of minimally invasive treatment of early osteonecrosis of femoral head (ONFH) with hydroxyapatite coated hollow titanium rod. Methods: From 1, January 2003 to 1, January 2019, 72 patients with ONFHⅡ Stage were selected. There were 50 males and 20 females, aged from 28 to 56. Onset time was 8~28 months. Lesion site: 18 left, 38 right, 16 bilateral. Causes of ONFH: 30 alcohol, 28 hormone, 9 trauma and 5 idiopathic patients. ARCO stage: 14 IIA, 33 IIB, 25 IIC. All patients underwent arthroscopic assisted minimally invasive percutaneous core decompression and bone grafting with hydroxyapatite coated titanium rod surgery. Visua Analogue Scales (VAS), Harris score and Images were used for assessing pain, hip joint function and the stability, respectively. Hip replacement was performed finally. Results: 16 patients with heavy hormone use history and femoral head collapse underwent Total Hip Resurfacing Arthroplasty (THRA) at the last follow-up. 24 months later, 8 ⅡB cases progressed to ⅡC, 2 cases were stable at ⅡC, 6 cases increased to Ⅲ, and underwent THRA. 12ⅡC cases progressed to Ⅲ, 2 cases were stable at Ⅲ, and 10 cases had articular cartilage surface collapse. THRA was administered 30 months after surgery. VAS score of individual patients increased and Harris score decreased 24 months after surgery, but there was no significant difference between the scores of 12 months and 24 months. The clinical effect of the last follow-up showed that the postoperative improvement rate of this group was 76.13%, among which the best was 100% in IIA, 79.48% in IIB, and the lowest was 58.06 in IIC. Both the patients with IIB or IIC, cases with aggravation and without change were hormonal ONFH. Conclusion: The treatment of ONFH with hydroxyapatite coated hollow titanium rod supporting the femoral head to prevent collapse is feasible. In addition to the Glucocorticoid-induced ONFH stage ⅡC outside, this method to other Ⅱ period lesions in improving the curative effect and preventing the collapse of femoral head articular surface is good and safe.

scholarly journals Clinical Study on the Minimally Invasive Treatment of Early Necrosis of the Femoral Head With Hydroxyapatite Coated Hollow Titanium Rod Supporting the Femoral Head to Prevent Collapse

2020 ◽  
Author(s):  
Xinmin Yang ◽  
Liangbin Gao ◽  
Bo Li ◽  
Xumin Hu ◽  
Di Zhang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Minimally Invasive ◽  
Articular Surface ◽  
Onset Time ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Improvement Rate ◽  
Significant Difference ◽  
Harris Score

Abstract Background: To investigate the treatment effect of minimally invasive treatment of early osteonecrosis of femoral head (ONFH) with hydroxyapatite coated hollow titanium rod. Methods: From 1, January 2003 to 1, January 2019, 72 patients with ONFHⅡ Stage were selected. There were 50 males and 20 females, aged from 28 to 56. Onset time was 8~28 months. Lesion site: 18 left, 38 right, 16 bilateral. Causes of ONFH: 30 alcohol, 28 hormone, 9 trauma and 5 idiopathic patients. ARCO stage: 14 IIA, 33 IIB, 25 IIC. All patients underwent arthroscopic assisted minimally invasive percutaneous core decompression and bone grafting with hydroxyapatite coated titanium rod surgery. Visua Analogue Scales (VAS), Harris score and Images were used for assessing pain, hip joint function and the stability, respectively. Hip replacement was performed finally. Results: 16 patients with heavy hormone use history and femoral head collapse underwent Total Hip Resurfacing Arthroplasty (THRA) at the last follow-up. 24 months later, 8 ⅡB cases progressed to ⅡC, 2 cases were stable at ⅡC, 6 cases increased to Ⅲ, and underwent THRA. 12ⅡC cases progressed to Ⅲ, 2 cases were stable at Ⅲ, and 10 cases had articular cartilage surface collapse. THRA was administered 30 months after surgery. VAS score of individual patients increased and Harris score decreased 24 months after surgery, but there was no significant difference between the scores of 12 months and 24 months. The clinical effect of the last follow-up showed that the postoperative improvement rate of this group was 76.13%, among which the best was 100% in IIA, 79.48% in IIB, and the lowest was 58.06 in IIC. Both the patients with IIB or IIC, cases with aggravation and without change were hormonal ONFH. Conclusion: The treatment of ONFH with hydroxyapatite coated hollow titanium rod supporting the femoral head to prevent collapse is feasible. In addition to the Glucocorticoid-induced ONFH stage ⅡC outside, this method to other Ⅱ period lesions in improving the curative effect and preventing the collapse of femoral head articular surface is good and safe.

scholarly journals Effect of Osteonecrosis Intervention Rod Versus Core Decompression Using Multiple Small Drill Holes on Early Stages of Necrosis of the Femoral Head: A Prospective Study on a Series of 60 Patients with a Minimum 1-Year-Follow-Up

2015 ◽  
Vol 9 (1) ◽  
pp. 179-184 ◽  
Author(s):  
Haixiong Miao ◽  
Dongping Ye ◽  
Weiguo Liang ◽  
Yicun Yao
Keyword(s):  
Femoral Head ◽  
Core Decompression ◽  
Alternative Methods ◽  
Early Stages ◽  
Significant Difference ◽  
Harris Score ◽  
The Mean ◽  
Drill Holes ◽  
Partial Weight

Introduction: The conventional CD used 10 mm drill holes associated with a lack of structural support. Thus, alternative methods such as a tantalum implant, small drill holes, and biological treatment were developed to prevent deterioration of the joint. The treatment of CD by multiple 3.2 mm drill holes could reduce the femoral neck fracture and partial weight bearing was allowed. This study was aimed to evaluate the effect of osteonecrosis intervention rod versus core decompression using multiple small drill holes on early stages of necrosis of the femoral head. Method: From January 2011 to January 2012, 60 patients undergoing surgery for osteonecrosis with core decompression were randomly assigned into 2 groups based on the type of core decompression used: (1) a total of 30 osteonecrosis patients (with 16 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with a porous tantalum rod insertion. The diameter of the drill hole for the intervention rod was 10mm.(2) a total of 30 osteonecrosis patients (with 14 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with core decompression using five drill holes on the lateral femur, the diameter of the hole was 3.2 mm. The average age of the patient was 32.6 years (20-45 years) and the average time of follow-up was 25.6 months (12- 28 months) in the rod implanted group. The average age of the patient was 35.2 years (22- 43 years) and the average time of follow-up was 26.3 months (12-28 months) in the small drill holes group. Results: The average of surgical time was 40 min, and the mean volume of blood loss was 30 ml in both surgical groups. The average of Harris score was improved from 56.2 ± 7.1 preoperative to 80.2 ± 11.4 at the last follow-up in the rod implanted group (p < 0.05). The mean Harris score was improved from 53.8 ± 6.6 preoperative to 79.7 ± 13.2 at the last follow-up in the small drill holes group (p<0. 05). No significant difference was observed in Harris score between the two groups. At the last follow-up, 28 of 36 hips were at the same radiographic stages as pre-operation, and 8 deteriorated in the rod implanted group. 26 of 34 hips were at the same radiographic stage as pre-operation, and 8 deteriorated in the small drill holes group. No significant difference was observed in radiographic stage between the two groups. There was no favourable result on the outcome of a tantalum intervention implant compared to multiple small drill holes. Discussion: CD via multiple small drill holes would allow similar postoperative load-bearing and seems to result in similar or even better clinical outcome without the prolonged implantation of an expensive tantalum implant. A tantalum rod intervention and core decompression using multiple small drill holes were effective on the stage I hips rather than stage II hips.

scholarly journals Autologous Bone Marrow Mononuclear Cells (BMMCs) for the Treatment of Uncomplicated Grade 2 Ununited Anconeal Process (UAP) in Six Dogs: Preliminary Results

2021 ◽  
Vol 8 (10) ◽  
pp. 214
Author(s):  
Alberto Maria Crovace ◽  
Luca Lacitignola ◽  
Mariasevera Di Comite ◽  
Cosimo Esposito ◽  
Alessandro Guarracino ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Minimally Invasive ◽  
Autologous Bone Marrow ◽  
Minimally Invasive Treatment ◽  
Bone Marrow Mononuclear Cell ◽  
Invasive Treatment ◽  
German Shepherd ◽  
Ossification Centre ◽  
Autologous Bone

The aim of this study was to report the results of autologous bone marrow mononuclear cell (BMMC) transplantation as a minimally invasive treatment for grade 2 UAP in dogs. This was an observational case series on six German shepherd dogs affected by grade 2 UAP as defined according to their clinical condition as well as radiographic and CT findings. Bone marrow was collected from the iliac crest and the mononuclear fraction was separated with density gradient centrifugation. Cells were suspended in fibrin glue before BMMC administration and implanted via transcutaneous injection under IB or CT guidance, using a spinal needle directly inserted into the ossification centre between the anconeal process and the olecranon. Clinical and radiographic follow-up was performed for up to 6 months. Microradiographic assessment was performed on one dog that died of other causes. A progressive reduction of pain within 3 weeks after BMMC administration was observed in all dogs, with gradually increased weight bearing on the affected limb. Radiographic and CT follow-up revealed the progressive fusion of the ossification centre at 90 days without any signs of secondary OA. The examination of microradiographs showed newly formed bone tissue in which a residue of calcified cartilage was present at the site of BMMC implantation. On the basis of these results, BMMC therapy for grade 2 UAP may be considered to be an effective and minimally invasive treatment option for dogs.

The Spatial Weaving Screw Technique Combined With Minimally Invasive Treatment of Calcaneal Fracture

2021 ◽  
Author(s):  
Yong Zhang ◽  
Qiuyan Weng ◽  
Jianming Chen ◽  
Yunfeng Yang
Keyword(s):  
Minimally Invasive ◽  
Articular Surface ◽  
Wound Complication ◽  
Clinical Results ◽  
Healing Time ◽  
X Rays ◽  
Type Ii ◽  
Invasive Treatment ◽  
Surgical Methods

Abstract Background: The conventional surgical method for calcaneal fractures is the extensile lateral approach to reduce and fix fractures using plates and screws, Unfortunately, this method has been associated with high rates of wound and steel plate complications. Similarly, it is still difficult for minimally invasive surgical methods to achieve effective reduction and internal fixation. Therefore, this article proposes a new method of lateral minimally invasive incision combined with percutaneous, screw-only fixation and the screws are individually knitted according to the type of fracture.Methods: Between October 2015 and October 2019, 31 patients who underwent the spatial weaving screw technique combined with minimally invasive were recruited. Any operative complication was recorded. The clinical results were evaluated based on pre-operative X-rays (axial and lateral calcaneus), CT and three-dimensional reconstruction, AOFAS, VAS during follow-up.Results: Bone healing was achieved in all patients, with an average healing time of 7.3±4.2ml weeks. No serious complications occurred after operation, no case of reduction failure or screw displacement were found. The evaluation of the posterior subtalar and calcaneocuboid articular surface respectively showed 80.6% and 90.3% cases got excellent and good reduction. The average AOFAS score was 89.5 at the end of 1 year after the operation, the mean VAS in our series was 2.4 at the last follow-up. Conclusion: Combined with minimally invasive screw spatial weaving technique, displaced Sanders type II and III can be successfully treated displaced Sanders type II and III fractures. The method allows for adequate reduction and effective fixation by screws. It also clearly avoids the major wound complication problems, improve the accuracy of reduction and implantation, simplify surgical procedure.

Minimally invasive treatment for osteonecrosis of the femoral head with angioconductive bioceramic rod

2018 ◽  
Vol 42 (7) ◽  
pp. 1567-1573 ◽  
Author(s):  
Yajie Lu ◽  
Xiao Lu ◽  
Minghui Li ◽  
Xiantao Chen ◽  
Youwen Liu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Minimally Invasive ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment

scholarly journals SURG-25. LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR INTRACRANIAL LESIONS: A SINGLE- INSTITUTIONAL SERIES, OUTCOMES AND REVIEW OF THE LITERATURE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi244-vi245
Author(s):  
Rocco Dabecco ◽  
Alexander Yu ◽  
Tulika Ranjan ◽  
Linda Xu ◽  
Khaled Aziz
Keyword(s):  
Minimally Invasive ◽  
Brain Metastases ◽  
Metastatic Disease ◽  
Progression Free Survival ◽  
Treatment Method ◽  
Thermal Therapy ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Laser Interstitial Thermal Therapy

Abstract INTRODUCTION Laser interstitial thermal therapy (LITT) is a minimally invasive treatment method that provides surgeons with cytoreductive techniques to treat neurosurgical conditions such as primary brain neoplasms, brain metastases, radiation necrosis, and epileptogenic lesions, many of which are located in operative corridors that would be difficult to address via open surgical or are amenable via minimally invasive approaches. Although the use of lasers is not a new concept in neurosurgery, advances in technology have enabled surgeons to perform laser treatment with the aid of real-time MRI thermography as a guide. In this report, we present our institutional series and outcomes of patients treated with LITT for 8 glial neoplasms 12 brain metastases. METHODS We retrospectively evaluated 20 patients (7 male, 13 female; age range, 28–77 years) who underwent LITT at one or more targets from 2015–2019. RESULTS In our series, all patients included had prior craniotomy for either primary glioma or metastatic disease. Mean extent of ablation (EOA) was 98% on post-op MRI. Mean progression free survival varied depending on the intracranial pathology, with the glioma cohort (5 months (SDD: 3.51)) demonstrating worse outcomes than metastatic disease (8.2 months (SDD: 4.83)). Only 1 patient experienced immediate post-operative morbidity, 1 patient experienced post-operative mortality secondary to hemorrhage. Mean follow-up was 9.7 months (SDD: 5.35), with one patient lost to follow up immediately post-procedure and excluded from the study. Average hospitalization was 2.4 days (SDD: 1.0). Mean overall survival, post-diagnosis of intracranial lesion, is more favorable for metastatic lesions (48 months (SDD: 27.14)), as compared to primary glial neoplasms (31 months SDD: 11.63)). CONCLUSION Laser interstitial thermal therapy (LITT) is a safe, minimally invasive treatment method that provides surgeons with cytoreductive techniques to treat neurosurgical conditions. In properly selected patients, this modality offers improved survival outcomes in conjunction with other salvage therapies.

scholarly journals TRANSANAL DOPPLER-CONTROLLED DEARTERIALIZATION WITH MUCOPEXY FOR A MINIMALLY INVASIVE TREATMENT OF HAEMORRHOIDAL DISEASE

2016 ◽  
pp. 26-31 ◽  
Author(s):  
E. A. Zagryadskiy
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Artery Ligation ◽  
Haemorrhoidal Disease ◽  
Effective Form ◽  
Number Of Patients ◽  
Grade Ii ◽  
Disease Grade

Transanal Doppler-controlled, deartetialization with mucopexy - a new direction in minimally invasive treatment Haemorrhoidal disease grade II and IV. The number of patients showing relief of Haemorrhoidal symptoms at 52-month follow-up was high. Bleeding was resolved in 92.9% of the patients. The recurrence of prolapse at 52 months was low, with no re-prolapse being recorded in 89,6% of the patients. Doppler-guided Haemorrhoidal artery ligation with transanal rectal mucopexy, not only has several perioperative advantages - minimally invasive surgery, low major complications - but also offers prolonged relief for all hemorrhoidal symptoms. Technology is an effective form of treatment for hemorrhoidal disease.

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