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.

New Method for the Treatment of Early Forms of Femoral Head Aseptic Necrosis (Preliminary Report)

2011 ◽  
Vol 18 (1) ◽  
pp. 33-37
Author(s):  
Il'dar Fuatovich Akhtyamov ◽  
O G Anisimov ◽  
Yu V Budyak ◽  
A N Kovalenko ◽  
A S Korotkova ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Conservative Treatment ◽  
Preliminary Report ◽  
Pain Syndrome ◽  
Course Completion ◽  
New Method ◽  
Functional Abilities ◽  
Joint Region ◽  
Aseptic Necrosis

The authors have elaborated a new method for conservative treatment of femoral head aseptic necrosis (FHAN) at early stages of the disease (prior to cartilaginous layer collapse). The method consists of performance of prolonged epidural analgesia by administration of local anesthetic through epidural catheter with dosed speed for 6 - 8 days. Drug sympathectomy results in vascular tension drop that favours the improvement of microcirculation in hip joint region. Results of that method application in 24 patients show that it enables to cup off the pain syndrome and restore patient's functional abilities directly after treatment course completion. Remission lasts for up to 12 months. Application of the proposed method enables to postpone performance of total hip arthroplasty for the period of up to 6 years.

scholarly journals Use of Perfotran at Conservative Treatment of Early Stages of Femoral Head Avascular Necrosis

2015 ◽  
Vol 22 (4) ◽  
pp. 26-31
Author(s):  
V. M Prokhorenko ◽  
A. G Shusharin ◽  
M. P Polovinka
Keyword(s):  
Femoral Head ◽  
Conservative Treatment ◽  
Avascular Necrosis ◽  
Pain Syndrome ◽  
Harris Hip Score ◽  
Treatment Results ◽  
Early Stages ◽  
Reduction Of Pain ◽  
Group 2

Conservative treatment results are presented for 328 patients with I-II stages of femoral head avascular necrosis (FHAN) at 3 years follow up term. Uni- or bilateral coxarthrosis was observed in 157 patients. Patients were on intraarticular injections of perfotran (1st group; n=102) or perfotran+dimexide mixture (2nd group; n=226). Clinical and functional hip joint condition was evaluated by Harris Hip Score. Positive dynamics was noted in all patients however in group 2 it was more marked: absence of negative dynamics was recorded in 204 (90.2%) patients; restorative process, by MRI examination results, was noted in 105 (46.5%) patients; significant reduction of pain syndrome was achieved. Algorithm for the management of patients with early stages of FHAN was proposed.

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.

scholarly journals Corrective Intertrochanteric Osteotomy of the Femur for Aseptic Necrosis of the Femoral Head after Bloodless Reduction of Congenital Dislocation in School-Age Children

2021 ◽  
Vol 07 (10) ◽  
Author(s):  
Khojaakhmed Shaykhislamovich Alpysbaev ◽  
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Hip Dislocation ◽  
School Age Children ◽  
Congenital Dislocation ◽  
School Age ◽  
Greater Trochanter ◽  
Congenital Hip Dislocation ◽  
Aseptic Necrosis ◽  
Results Of Treatment

The immediate results of treatment of 72 children aged 7 to 12 years with aseptic necrosis of the femoral head after bloodless reduction of congenital hip dislocation were analyzed. When treating patients, the following types of surgical treatment were used:extra-articular or open centering of the femoral head with intertrochanteric-torsion-varizing or devarizing and rotational osteotomy of the femur with bringing down the greater trochanter in the caudal direction. In all patients, pain and lameness disappeared, internal rotation of the lower extremities when walking, and the range of motion in the hip joint improved. Improved radiometric parameters characterizing the ratio of the acetabulum and the head of the femur and the angular values of the hip joint and proximal femur.

scholarly journals Results of Treatment for Aseptic Necrosis of the Femoral Head with Vascularized Bone Graft.

1992 ◽  
Vol 40 (3) ◽  
pp. 962-964
Author(s):  
Kosei Ijiri ◽  
Nagatoshi Yoshikuni ◽  
Hidefumi Kawaida ◽  
Hiroshi Ito ◽  
Mitsuhiro Yanase ◽  
...  
Keyword(s):  
Femoral Head ◽  
Bone Graft ◽  
Vascularized Bone Graft ◽  
Aseptic Necrosis ◽  
Results Of Treatment ◽  
Vascularized Bone

scholarly journals Diagnostic methods and classifications of aseptic necrosis of the femoral head

TRAUMA ◽  
2019 ◽  
Vol 20 (5) ◽  
pp. 88-96
Author(s):  
I.M. Zazirnyi ◽  
V.G. Klimovytskyi ◽  
I.P. Semeniv ◽  
O.M. Mikhalchenko ◽  
B.S. Ryzhkov
Keyword(s):  
Femoral Head ◽  
Diagnostic Methods ◽  
Aseptic Necrosis

scholarly journals Reconstruction of a hip socket using trabecular metal components

2019 ◽  
Vol 26 (1) ◽  
pp. 5-10
Author(s):  
N. V Zagorodny ◽  
O. A Alexanyan ◽  
G. A Cragan ◽  
S. V Kagramanov ◽  
B. U Iwunze
Keyword(s):  
Femoral Head ◽  
Bone Tissue ◽  
Hip Joint ◽  
Conflict Of Interest ◽  
Hip Prosthesis ◽  
Bone Defects ◽  
Structural Features ◽  
Harris Hip Score ◽  
Trabecular Metal ◽  
Aseptic Necrosis

Introduction. Fixation of the acetabular component in patients with bone defects of the acetabulum is a difficult task due to the insufficient quantity and poor quality of the remaining bone tissue. During the last few years in our country in arthroplasty of the acetabulum with severe bone defects were actively used implants made of trabecular metal. Purpose of study: was to evaluate short-term clinical and radiological results of the usage of trabecular metal components in patients with bone defects in revision and primary hip replacement. Patients and methods. 59 surgeries were performed using components of trabecular metal, 53 of them were performed on the instability of the hip prosthesis, 2 - post-traumatic hip dysplasia, 2 - aseptic necrosis of the femoral head, 2 - high dislocation of the femoral head. Among the operated there were 37 women and 22 men, the average age was 58.2±19.9 years. According to the Paprosky classification, defects in 12 cases corresponded to type IIA, in 14 - type IIB, in 6 - type II, in 19 - type IIIA, in 7 - type IIIB. The structural features of these implants, made of tantalum in a carbon skeleton with uniform porosity, similar to the structure of bone tissue, provide an increased coefficient of friction, thereby contributing to the rapid growth of bone tissue in the implant structure. Results. The average follow-up period was 14 months. The average preoperative assessment of the hip joint by Harris Hip Score (HHS) was 43 points (from 14 to 86). After surgery, the average HHS improved to 88.7 (69 to 100). 1 patient had hemorrhagic discharge after surgery. On the 7th day an audit was performed. In 2 cases, paresis of the peroneal portion of the sciatic nerve developed after surgery. There were no cases of recurrent dislocations, deep infection, pulmonary embolism or death as a result of operations. Conclusion. Taking into account the mechanical properties, tantalum implants allow to achieve a stable primary fixation with the restoration of the center of rotation of the hip joint and eliminate the risks associated with the use of allografts. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

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 Application of the complex algorithm for rehabilitation of patients needing a full reconstruction of dentition (clinical case)

2020 ◽  
Vol 24 (3) ◽  
pp. 158-163
Author(s):  
Fatima K. Dzalaeva ◽  
S. O. Chikunov ◽  
A. S. Utyuzh ◽  
Z. K. Dzhagaeva ◽  
A. V. Yumashev
Keyword(s):  
Clinical Case ◽  
Myofascial Pain ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Diagnostic Methods ◽  
Instrumental Analysis ◽  
Results Of Treatment ◽  
Full Reconstruction ◽  
Complex Algorithm

Introduction. Aim of the study is testing the algorithm of complex clinical, functional and instrumental analysis in the treatment of patients with the need for total restoration of the dentition with manifestations of myofascial pain syndrome. Material and methods. A system for the rehabilitation of patients with adentia is proposed, in which, when planning occlusion correction, objective examination data for patients obtained using a set of diagnostic methods should be taken into account. Particular attention is paid to assessing the function of the temporomandibular joint and the presence of pathological signs of disorders of maxillofacial muscles. Results. A clinical case is described a patient who has been diagnosed with a set of indicators of clinical, functional and instrumental analysis obtained using methods of condylography and cephalometry. The results of treatment and rehabilitation measures allowed achieving the optimal distribution of loads on the dentition, while reducing the risk of ceramic chipping and improving oral hygiene. The approach used allowed timely correction of functional and aesthetic disorders. Conclusions. The algorithm for working with patients who need total restoration of the dentition should include a thorough history taking, clinical functional analysis using condylography methods, model analysis to register and evaluate the static and dynamic ratios of the dentition. As well as performing cephalometric analysis and other manipulations, in accordance with standard criteria for clinical examination. The developed algorithm is anatomically and pathogenetically justified, since it takes into account the entirety of changes and interconnections of the structures of the dentofacial system and other body systems that underlie the clinical manifestations in this category of patients.

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