Evaluation of the effectiveness of hip arthroscopy in the surgical treatment of ANFH in adults

During 2017–2021 in the facilities of the orthopedic department of the Khabarovsk Krai Clinical Hospital named after prof. O.V. Vladimirtseva patients with avascular necrosis of the femoral head (ANFH) stages 0, 1 and 2 have been surgically treated with minimally invasive two-stage decompression with bone alloplasty. The results of radiological diagnosis and arthroscopic picture in the initial stages of the disease were evaluated. The results obtained, the identity of the MRI diagnostic data and the arthroscopic featers indicate the unreasonableness of performing therapeutic and diagnostic arthroscopy in combination with tunnelization, revision of the femoral head cyst and further alloplasty in stages 1 and 2 of the disease, which does not exclude the possibility of using this technology in other stages of ANFH

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Results of applying minimally invasive two-stage decompression with bone alloplasty for avascular necrosis of the femoral head

Practical medicine ◽

10.32000/2072-1757-2021-3-69-74 ◽

2021 ◽

Vol 19 (3) ◽

pp. 69-74

Author(s):

A. V. ANTONOV ◽

◽

V. E. VOLOVIK ◽

A. G. RYKOV ◽

S. N. BEREZUTSKIY ◽

...

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Minimally Invasive ◽

Avascular Necrosis ◽

Hip Joint ◽

Rapid Development ◽

Young Patients ◽

Walking Distance ◽

Joint Function ◽

Two Stage

Avascular necrosis of the femoral head is a complex medical and social problem. The rapid development of the disease, the complexity of diagnosis and the prevalence among young patients leads to impaired hip joint function and further disability. To improve the quality of life of patients, the Orthopedic Department of the Traumatology Center of Khabarovsk developed a method of minimally invasive two-stage decompression. Surgical treatment was performed in 30 cases in patients with ANFH of stages 0, 1, 2 (by ARCO). Evaluation of treatment results was carried out before operative treatment, after 6 and 12 months. 12 months after surgical treatment, positive dynamics was noted, namely, pain reduction, a walking distance increase, abandonment of crutches, opportunity to use public transport, ability to sit for a long time in one and the same position, to put on shoes, and the abandonment of constant intake of non-steroidal anti-inflammatory drugs. The assessment of hip joint function in 20% of cases showed an excellent result, in 26,6% of cases — a good result, in 40% — satisfactory, and in 13,3% (4 people) — unsatisfactory result, which proves the effectiveness of the proposed treatment method and the feasibility of its use.

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Surgical treatment for advanced stage of avascular necrosis of the femoral head in adults

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd006079 ◽

2006 ◽

Author(s):

Brigitte M. Jolles ◽

Jacky Michel ◽

Bernard Burnand ◽

Pierre-François Leyvraz

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Avascular Necrosis ◽

Advanced Stage

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Avascular Necrosis of the Femoral Head after Hip Arthroscopy

Hip International ◽

10.5301/hip.2011.8693 ◽

2011 ◽

Vol 21 (5) ◽

pp. 623-626 ◽

Cited By ~ 17

Author(s):

Nadir Sener ◽

Abdullah Gogus ◽

Senol Akman ◽

Azmi Hamzaoglu

Keyword(s):

Femoral Head ◽

Avascular Necrosis ◽

Hip Arthroscopy

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Long-term Outcome of Multiple Small-diameter Drilling Decompression Combined with Hip Arthroscopy versus Drilling Alone for Early Avascular Necrosis of the Femoral Head

Chinese Medical Journal ◽

10.4103/0366-6999.207470 ◽

2017 ◽

Vol 130 (12) ◽

pp. 1435-1440 ◽

Cited By ~ 5

Author(s):

Ji Li ◽

Zhong-Li Li ◽

Hao Zhang ◽

Xiang-Zheng Su ◽

Ke-Tao Wang ◽

...

Keyword(s):

Femoral Head ◽

Avascular Necrosis ◽

Hip Arthroscopy ◽

Small Diameter ◽

Term Outcome ◽

Long Term Outcome

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Hip arthroscopy for femoroacetabular impingement

EFORT Open Reviews ◽

10.1302/2058-5241.3.170041 ◽

2018 ◽

Vol 3 (4) ◽

pp. 121-129 ◽

Cited By ~ 4

Author(s):

Rima Nasser ◽

Benjamin Domb

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Conservative Treatment ◽

Learning Curve ◽

Femoroacetabular Impingement ◽

Hip Arthroscopy ◽

Dynamic Condition ◽

Treatment Options ◽

Femoral Offset ◽

Chondral Damage

The purpose of this article is to give a general overview of femoroacetabular impingement (FAI) and how it could be treated arthroscopically, with some details about indications, the procedure itself and some of the complications associated with the surgery. FAI is a dynamic condition of the hip that can be a source of pain and disability and could potentially lead to arthritis. When symptomatic, and if conservative treatment fails, FAI can be addressed surgically. The goal of surgical treatment for FAI is to recreate the spherical contour of the femoral head, improve femoral offset, normalize coverage of the acetabulum, repair/reconstruct chondral damage and repair/reconstruct the labrum to restore normal mechanics and joint sealing. Advances in equipment and technique have contributed to an increase in the number of hip arthroscopy procedures performed worldwide and have made it one of the more common treatment options for symptomatic FAI. Hip arthroscopy is a procedure with an extremely steep and long learning curve. Cite this article: EFORT Open Rev 2018;3:121-129. DOI: 10.1302/2058-5241.3.170041

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Core Decompression by Laser Osteoperforation: A Preliminary Report of New and Minimally Invasive Modality for the Treatment of Avascular Necrosis of the Femoral Head

Malaysian Journal of Medical and Biological Research ◽

10.15590/mjmbr/2014/v1i1/53715 ◽

2014 ◽

Vol 1 (1) ◽

pp. 9

Author(s):

Yakub M. Ali ◽

Jahangir M. Sarwar ◽

Manash C. Sarker ◽

Mohammad S. Hossain ◽

Muhammad N. Kayes ◽

...

Keyword(s):

Femoral Head ◽

Minimally Invasive ◽

Avascular Necrosis ◽

Preliminary Report ◽

Core Decompression

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Core Decompression by Laser Osteoperforation: A Preliminary Report of New and Minimally Invasive Modality for the Treatment of Avascular Necrosis of the Femoral Head

Malaysian Journal of Medical and Biological Research ◽

10.18034/mjmbr.v1i1.370 ◽

2014 ◽

Vol 1 (1) ◽

pp. 9-17

Author(s):

Yakub M. Ali ◽

Jahangir M. Sarwar ◽

Manash C. Sarker ◽

Mohammad S. Hossain ◽

Muhammad N. Kayes ◽

...

Keyword(s):

Femoral Head ◽

Minimally Invasive ◽

Avascular Necrosis ◽

Core Decompression ◽

Harris Hip Score ◽

Invasive Treatment ◽

Intraosseous Pressure ◽

Radiological Staging ◽

Reparative Process ◽

Surgical Treatments

Introduction: Avascular necrosis (AVN) of the femoral head is a devastating disease that often leads to the destruction of the hip. Core decompression of femoral head is the commonest of all conservative surgical treatments where an 8-10 mm cylindrical core of bone is removed from antero-lateral segment of the femoral head. But it is employed only in early stages of the disease and its results are still of controversial efficacy and most of patients ultimately require total hip arthroplasty. Laser irradiation stimulates the reparative process in the bone and marrow while local hyperthermia produced by the laser vaporizes some of necrotic areas leading to a reduction of the intraosseous pressure which is the fulcrum of AVN regardless of the cause. Objectives: The aim of this experimental study was to evaluate the outcome of core decompression by laser osteoperforation for AVN of the femoral head. Subjects and methods: The study was carried out at the Institute of Laser Surgery and Hospital, Dhaka, Bangladesh which included 62 hips with AVN in 40 patients. Preoperative and Postoperative Clinical assessment and Radiological staging were done using ‘Harris Hip Score (HHS)’ and ‘Ficat and Arlet staging’ respectively. Under spinal anesthesia and Fluoroscopic guidance all hips were subjected to ‘Core decompression by Laser Osteo-perforation’ using 970 nm Diode laser through 18G spinal needle via trans-trochanteric and trans-capital approach. Results: All patients were followed up at intervals of three weeks, three months, six months and then yearly (cases with minimum 3 follow ups were included in this study). According to HHS our results are as : 40.3% - excellent; 21.0% - good; 29.0% - fair; 9.7% - poor. No significant side effects or complications were observed so far. Conclusion: Core decompression by laser osteoperforation has been proven so far to be an effective, safe and minimally invasive treatment modality for AVN of the femoral head.

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Prevalence Study of Femoral Head Avascular Necrosis and Evaluating Mutual Connection between Injury and Viral Infections: Clinical Analysis and Brief Review

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v30i430280 ◽

2019 ◽

pp. 1-7

Author(s):

Ali Yeghaneh ◽

Mehdi Moghtadaei ◽

Amir Sobhani Eraghi ◽

Mani Mahdavi ◽

Babak Otoukesh

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Avascular Necrosis ◽

Viral Infections ◽

Clinical Symptoms ◽

Clinical Analysis ◽

Immunosuppressive Drugs ◽

Hiv Patients ◽

Treatment Prevalence ◽

History Of

Avascular necrosis (AVN) could remain with negligible clinical symptoms, but it would get worsen over the time if it’s left untreated and at the most cases will require surgical treatment. Prevalence of femoral head AVN is almost 0.45% among HIV patients which is approximately 45 times more than the rest of Society. AVN occurs 0.088%-1.33% annually among HIV victims. Avascular necrosis of the femoral head is a bone deteriorating plight. At this study, the clinical prevalence of it has been analyzed among a group of 180 patients at Rasool-e-Akram Hospital (Iran, between 2008 and 2016). Patients were including 121 men and 59 women. Analysis results showed that the prevalence of HCV, HBV, and HIV was 1.7%, 1.1%, and 1.1% respectively. It was found that 63% of patients was currently using immunosuppressive drugs. 17% had a history of drug abuse among which 3.3% were using IV drugs. It was concluded that femoral head AVN is more common among hepatitis and HIV patients.

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Surgical treatment of children with hip dysplasia complicated with avascular necrosis of the femoral head

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors7125-34 ◽

2019 ◽

Vol 7 (1) ◽

pp. 25-34

Author(s):

Mikhail P. Teplenky ◽

Evgeny V. Oleinikov ◽

Vyacheslav S. Bunov

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Avascular Necrosis ◽

Hip Dysplasia ◽

Hip Dislocation ◽

Functional Results ◽

X Ray ◽

Group 2 ◽

Time Of Operation ◽

Group 1

Introduction. Avascular necrosis of the femoral head complicates the surgical treatment of hip dysplasia and aggravates the prognosis. Aim. We studied the immediate and medium-term results of reconstructive treatment in 18 children with hip dysplasia complicated by avascular femoral head necrosis, which developed after closed repositioning of a congenitally dislocated femur. Material and methods. Average age at the time of operation was 4.2 0.2 years. The patients were divided into two groups. Group 1 included 12 children with hip subluxation who underwent extra-articular reconstructions on articular components, spinal tunneling of the neck and head, and hardware unloading of the joint and group 2 included six patients with hip dislocation in whom an additional open reduction was performed. Functional results were estimated using DAubigne-Postel classification, whereas X-ray results were evaluated using Kruczynski classification. Results. Duration of observation was 37 years (average, 4.2 0.3 years). Functional results were good (1518 points) in nine joints in group 1, satisfactory (1214 points) in three joints in group 1 and five in group 2, and unsatisfactory (11 points) in one joint in group 2. X-ray results were good in six joints in group 1, satisfactory in six joints in group 1 and five in group 2, and unsatisfactory in one joint in group 2. Conclusions. Extra-articular reconstructive and stimulatory interventions combined with hardware decompression helps improve the shape and structure of the femoral head, and formation of congruent articular surfaces in children with subluxation of the thigh complicated by avascular necrosis.

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