Inhibitory effects of vitamin E on osteocyte apoptosis and DNA oxidative damage in bone marrow hemopoietic cells at early stage of steroid-induced femoral head necrosis

Background: Pathological animal models provide the foundation for developing new methods for treating. This research aims to establish a rabbit model of femoral head necrosis. Osteonecrosis of the femoral head (ONFH) was induced in rabbits by using methylpresnisolone combined with Complete Freund's Adjuvant (CFA). New Zealand White rabbits were divided into two groups. Group A (n=10) was given an intramuscular injection of 0.5 mg/kg (CFA) and 40mg/kg methylprednisolone (MPS). Group B (n=6) was received normal saline at the same location and same volume as those in Group A. The efficiency of ONFH rabbit model was assessed at 7 weeks after the last injection. Body weight was weighed. The histological structure of head femoral and bone were deteded by H&E staining. The empty lacuna was counted. Cartilage degeneration was evaluated using image analysis software. Blood vessel density was assessed after ink artery infusion. The cell cycle of bone marrow-derived mononuclear cells was analyzed by flow cytometry. The results showed that there was no difference in body weight change of rabbits between two groups. However, the bone morphology and cartilage surface of femoral head were abnormalities at group A. The percentage of empty osteocyte lacunae were significantly higher in Group A than Group B. Chondrocyte degeneration and fibrocartilage expression were observed at Group A. Compare to group B, Group A had less ink-stained blood vessels. Moreover, the fraction of bone marrow-derived mononuclear at S phase and G2/M phase of the cell cycle was significantly decreased in group A. Thus, CFA combined with MPS can be used to establishing an early-stage femoral head necrosis model of rabbit.

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Development of an early-stage femoral head necrosis rabbit model using methylprednisolone and Complete Freund's Adjuvant

Biomedical Research and Therapy ◽

10.15419/bmrat.v4i11.379 ◽

2017 ◽

Vol 4 (11) ◽

pp. 1749

Author(s):

Lan Thi Phi ◽

Ha Thi -Ngan Le ◽

Thuy Thi -Thanh Dao ◽

Khanh Dinh-Van Nguyen ◽

Khanh Hong-Thien Bui ◽

...

Keyword(s):

Cell Cycle ◽

Bone Marrow ◽

Body Weight ◽

Femoral Head ◽

Mononuclear Cells ◽

Early Stage ◽

Rabbit Model ◽

Normal Group ◽

Femoral Head Necrosis ◽

Freund's Adjuvant

Introduction: Pathological animal models provide the foundation for developing new methods for disease treatment. This research aims to establish a rabbit model of femoral head necrosis. Methods: Osteonecrosis of the femoral head (ONFH) was induced in rabbits by using methylprednisolone (MPS) combined with Complete Freund's Adjuvant (CFA). New Zealand White rabbits were divided into two groups. ONFH group (n=10) was given an intramuscular injection of 0.5 mg/kg CFA and 40 mg/kg methylprednisolone. Normal group (n=6) received normal saline at the same location and same volume as those in ONFH group. The efficiency of the ONFH rabbit model was assessed at week 7 after the last injection. Body weight was detected, and the histological structure of head femoral and bone were assessed by H&E staining. The empty lacunae were counted. Cartilage degeneration was evaluated using image analysis software. Blood vessel density was assessed after ink artery infusion. The cell cycle of bone marrow-derived mononuclear cells was analyzed by flow cytometry. Results: The results showed that there was no difference in body weight changes of rabbits between the two groups. However, the bone morphology and cartilage surface of the femoral head showed abnormalities in the ONFH group. The percentage of empty osteocyte lacunae was significantly higher in ONFH group than normal group. Chondrocyte degeneration and fibrocartilage expression were observed in the ONFH group. Compared to the normal group, the ONFH group had less ink-stained blood vessels. However, the fraction of bone marrow-derived mononuclear cells in S phase and G2/M phase of the cell cycle was significantly increased in the ONFH group. Conclusion: Thus, CFA combined with MPS for 7 weeks can be used to establish an early-stage femoral head necrosis model in rabbits.

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The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1359-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 14

Author(s):

Kun-chi Hua ◽

Xiong-gang Yang ◽

Jiang-tao Feng ◽

Feng Wang ◽

Li Yang ◽

...

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Radiographic Progression ◽

Meta Analysis ◽

Core Decompression ◽

Femoral Head Necrosis ◽

Significant Difference ◽

Autologous Bone ◽

Necrosis Of Femoral Head ◽

Rate Of Success

Abstract Background Core decompression (CD) is an important method for the treatment of osteonecrosis of the femoral head (ONFH). Few articles investigate the influence of core decompression on outcomes of ONFH. This study was carried out to observe the safety and effectiveness of core decompression in the treatment of ONFH. Methods A comprehensive literature search of databases including PubMed, Embase, and Cochrane Library was performed to collect the related studies. The medical subject headings used were “femur head necrosis” and “Core decompression.” The relevant words in title or abstract included but not limited to “Osteonecrosis of the Femoral Head,” “femoral head necrosis,” “avascular necrosis of femoral head,” and “ischemic necrosis of femoral head.” The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Results Thirty-two studies included 1865 patients (2441 hips). Twenty-one studies (1301 hips) using Ficat staging standard, 7 studies (338hips) using Association Research Circulation Osseous (ARCO) staging standard, and University of Pennsylvania system for staging avascular necrosis (UPSS) staging criteria for 4 studies (802 hips). All the studies recorded the treatment, 22 studies (1379 hips) were treated with core decompression (CD) alone, and 7 studies (565 hips) were treated with core decompression combined with autologous bone (CD Autologous bone). Nine subjects (497 hips) were treated with core decompression combined with autologous bone marrow (CD Marrow). Twenty-seven studies (2120 hips) documented the number of conversion to total hip replacement (THA), and 26 studies (1752hips) documented the number of radiographic progression (RP). Twenty-one studies recorded the types of complications and the number of cases, a total of 69 cases. The random-effect model was used for meta-analysis, and the results showed that the overall success rate was 65%. The rate of success showed significant difference on the outcomes of different stages. The rate of success, conversion to THA, and radiographic progression showed significant difference on the outcomes of ONFH using different treatments. Conclusions Core decompression is an effective and safe method of treating ONFH. The combined use of autologous bone or bone marrow can increase the success rate. For advanced femoral head necrosis, the use of CD should be cautious. High-quality randomized controlled trials and prospective studies will be necessary to clarify the effects of different etiology factors, treatments, and postoperative rehabilitation. Until then, the surgeon can choose core decompression to treat ONFH depending on the patient’s condition. Level of evidence I Meta-analysis

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Addition of Bone Marrow Stem Cells Therapy Achieves Better Clinical Outcomes and Lower Rates of Disease Progression Compared With Core Decompression Alone for Early Stage Osteonecrosis of the Femoral Head: A Systematic Review and Meta-Analysis

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/jaaos-d-19-00816 ◽

2020 ◽

Vol 28 (23) ◽

pp. 973-979 ◽

Cited By ~ 3

Author(s):

Chaofan Zhang ◽

Xinyu Fang ◽

Zida Huang ◽

Wenbo Li ◽

Wenming Zhang ◽

...

Keyword(s):

Systematic Review ◽

Stem Cells ◽

Bone Marrow ◽

Femoral Head ◽

Disease Progression ◽

Clinical Outcomes ◽

Early Stage ◽

Meta Analysis ◽

Core Decompression ◽

Stem Cells Therapy

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Combining Concentrated Autologous Bone Marrow Stem Cells Injection With Core Decompression Improves Outcome for Patients with Early-Stage Osteonecrosis of the Femoral Head: A Comparative Study

The Journal of Arthroplasty ◽

10.1016/j.arth.2015.06.022 ◽

2015 ◽

Vol 30 (9) ◽

pp. 11-15 ◽

Cited By ~ 67

Author(s):

Reza Mostafavi Tabatabaee ◽

Sadegh Saberi ◽

Javad Parvizi ◽

Seyed Mohammad Javad Mortazavi ◽

Mahmoud Farzan

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Femoral Head ◽

Comparative Study ◽

Early Stage ◽

Core Decompression ◽

Autologous Bone Marrow ◽

Bone Marrow Stem Cells ◽

Autologous Bone

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Treatment of early stage osteonecrosis of the femoral head with implantation of autologous bone marrow-derived and cultured mesenchymal stem cells

http://isrctn.org/> ◽

10.1186/isrctn18167626 ◽

2012 ◽

Author(s):

Dewei Zhao

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Mesenchymal Stem Cells ◽

Femoral Head ◽

Early Stage ◽

Autologous Bone Marrow ◽

Autologous Bone

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Combination use of core decompression for osteonecrosis of the femoral head: A systematic review and meta-analysis using Forest and Funnel Plots

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1284149 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Linghanqing Wang ◽

XuRong Tian ◽

Keda Li ◽

Chunlei Liu

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Femoral Head ◽

Meta Analysis ◽

Core Decompression ◽

Autologous Bone Marrow ◽

Bone Marrow Stem Cell ◽

Femoral Head Necrosis ◽

Autologous Bone ◽

Marrow Stem Cell

Problem statement. Core decompression (CD) is a very significant process of dealing in the treatment of femoral head necrosis. And CD combined with bone marrow mesenchymal stem cell transplantation has been widely used in clinical practice, but its effectiveness is controversial. This study is carried out to observe its efficacy and outcomes. Objective. This study evaluated the efficacy and safety of CD combined with bone marrow stem cells in the treatment of femoral head necrosis by systematic review and meta-analysis. Methodology. PubMed, The Cochrane Library, Embase, CNKI, Google Scholar and MEDLINE, etc. databases were searched for clinical randomized controlled trials (RCTs) comparing core decompression combined with autologous bone marrow mesenchymal stem cells versus core decompression alone in the treatment of femoral head necrosis. The retrieval period is from the establishment of each database to May 20, 2021. After literature was extracted and literature quality was evaluated, meta-analysis was conducted by using RevMan5.3 software. Results. A total of 420 osteonecrosis of the femoral head 452 patients' data were collected from all studies. Compared with the core decompression alone group, the CD combined with bone marrow stem cell showed marked reduction in the Visual analog scale (VAS), enhanced Harris hip score (HHS) at 12 months and 24 months, slowed down the progression of the disease, decreased the number of hips conversed to total hip arthroplasty (THA) in the future. Conclusion. Core decompression therapy is a very effective and safe treatment process used for ONFH. Moreover, CD combined autologous bone marrow stem cell transplantation can improve the survival rate of the necrotic head, reduce hip pain and delay the disease progression, the rate of THA postoperatively.

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Intertrochanteric Corrective Osteotomy as a Joint-Saving Surgical Treatment for Femoral Head Necrosis

Hip International ◽

10.1177/1120700094004003-401 ◽

1994 ◽

Vol 4 (3-4) ◽

pp. 101-114

Author(s):

B.J. Berendsen ◽

C.J. Wirth ◽

H.V.D. Boom

Keyword(s):

Femoral Head ◽

Hip Joint ◽

Joint Replacement ◽

Clinical Symptoms ◽

Early Stage ◽

Corrective Osteotomy ◽

Femoral Head Necrosis ◽

Hip Joint Replacement ◽

Total Hip

Forty-seven intertrochanteric osteotomies were performed in 9 years on 40 patients with femoral head necrosis in Arlet and Ficat stages II and III in the Orthopaedic Department of the Medical School, Hannover. With an average follow up of 5.9 years (minimum 2.3 years, maximum 9.3 years), the study shows only 46% of the patients with satisfactory, good and very good results. After the joint saving operation, 26% of treated patients with pre-operative employment went into premature retirement. The average postoperative non-working period was 11 months (7-18 months). Clinical Relevance The results after the joint-saving operation were better when the operation was performed at an early stage of the disease with only a small area of necrosis. Although the operation will not prevent a progression of necrosis and a secondary arthrosis, we recommend that the joint-saving operation be performed during stages I and II to prolong the period before a total hip joint replacement becomes necessary. During stage III a total hip joint replacement may be preferable depending on clinical symptoms, patient age and the radiological findings (necrosis angle > 180°).

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The Role of99mTc-Annexin V Apoptosis Scintigraphy in Visualizing Early Stage Glucocorticoid-Induced Femoral Head Osteonecrosis in the Rabbit

BioMed Research International ◽

10.1155/2016/7067259 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Xiaolong Wang ◽

Yu Liu ◽

Xuemei Wang ◽

Rui Liu ◽

Jianbo Li ◽

...

Keyword(s):

Femoral Head ◽

Early Detection ◽

Bone Structure ◽

Early Stage ◽

Annexin V ◽

Bone Cell ◽

Tunel Assay ◽

Femoral Head Necrosis ◽

Femoral Head Osteonecrosis ◽

New Zealand White Rabbits

Objective. To validate the ability of99mTc-Annexin V to visualize early stage of glucocorticoid-induced femoral head necrosis by comparing with99mTc-MDP bone scanning.Methods. Femoral head necrosis was induced in adult New Zealand white rabbits by intramuscular injection of methylprednisolone.99mTc-Annexin scintigraphy and99mTc-MDP scans were performed before and 5, 6, and 8 weeks after methylprednisolone administration. Rabbits were sacrificed at various time points and conducted for TUNEL and H&E staining.Results. All methylprednisolone treated animals developed femoral head necrosis; at 8 weeks postinjection, destruction of bone structure was evident in H&E staining, and apoptosis was confirmed by the TUNEL assay. This was matched by99mTc-Annexin V images, which showed a significant increase in signal over baseline. Serial99mTc-Annexin V scans revealed that increased99mTc-Annexin V uptake could be observed in 5 weeks. In contrast, there was no effect on99mTc-MDP signal until 8 weeks. The TUNEL assay revealed that bone cell apoptosis occurred at 5 weeks.Conclusion.99mTc-Annexin V is superior to99mTc-MDP for the early detection of glucocorticoid-induced femoral head necrosis in the rabbit and may be a better strategy for the early detection of glucocorticoid-induced femoral head necrosis in patients.

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