femoral head necrosis
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2022 ◽  
Vol 12 (2) ◽  
pp. 386-392
Author(s):  
Haiyan Wei ◽  
Yubao Cui ◽  
Zhengjie Liu

To study the therapeutic effect of BMSCs on femoral head necrosis and whether it can inhibit the growth of OMgP. 15 healthy rats were divided into ZZ group (normal group), GT group (femoral head necrosis) and MM group (BMSCs transplantation). At 1 h, 3 h, 1 d, and 3 d, the expression of OMgP in GT group were higher than ZZ group (P <0.05) and MM group, indicating that BMSCs transplantation can decreased OMgP expression. At 1 d, 7 d, and 14 d, BBB scores of the GT group were lower than ZZ group (P < 0.05) and MM group (P < 0.05), indicating that BMSCs transplantation can improve spinal cord injury behavior. The cells in ZZ group were well stained and morphologically intact, the femoral head was not damaged, and the articular surface was smooth, GT group had cartilage necrosis with disordered inferior epiphysis, and the femoral head of the MM group had less damage and increased osteoblasts. The blood vessel counts in necrotic area in GT group were higher than ZZ group and MM group with decreased new bone area in repair area compared to ZZ and MM group (P <0.05), indicating that the area of femoral head necrosis after BMSCs transplantation was improved. The levels of ALP and BGP in GT group were lower than ZZ group (P <0.05) and MM group (P <0.05). Bone marrow mesenchymal stem cell transplantation can effectively repair new bone area, up-regulate ALP and BGP, and have a positive effect on femoral head necrosis, possibly by inhibiting OMGP activity.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Linghanqing Wang ◽  
XuRong Tian ◽  
Keda Li ◽  
Chunlei Liu

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.


2021 ◽  
Author(s):  
Run Tian ◽  
Sen Luo ◽  
Chunsheng Wang ◽  
Kunzheng Wang ◽  
Pei Yang

Abstract Background: To explore the clinical effect of robot-assisted core decompression combined with bone grafting in the treatment of femoral head necrosis involved in early stage.Methods: This study is a prospective cohort study. The study included 49 patients (78 hips) who attended the Department of Orthopedics and Joint Surgery of the Second Affiliated Hospital of Xi'an Jiaotong University from August 2019 to February 2021. All the patients suffering Association Research Circulation Osseous (ARCO) II stage of femoral head necrosis underwent core decompression and bone grafting. Among the patients undergoing surgery, 30 patients (54 hips) were treated with traditional surgical methods, and 19 patients (24 hips) were assisted by the made-in-China orthopedic robot system. All operations were performed by the same operator. The baseline data of the two groups of patients, the time of unilateral operation, the number of unilateral X-ray fluoroscopy, the Harris hip score (HHS) at the last follow-up after surgery, the visual analog score (VAS), and the collapse rate at the last follow-up were collected and compared. Results: A total of 41 patients (70 hips) were followed up, including 24 cases (42 hips) in the traditional surgery group and 17 cases in the robot-assisted group (28 hips). The average follow-up time of all cases was (13.9±3.4) months (range: 8-18 months). At the last follow-up, a total of 13 patients (13 hips) suffered femoral head surface collapse, including 11 patients in the traditional surgery group (11 hips) and 2 patients in the robot-assisted group (2 hips). The rate of femoral head collapse between the two groups had statistical difference. The average operation time of unilateral hip in the traditional operation group was (22.5±5.5) min, and (18.2±4.0) min in the robot-assisted group, with significant difference. The number of X-ray fluoroscopy of unilateral hip in the traditional operation group was (14.7±3.1) times, and (10.1±3.1) times in the robot-assisted group, with significant difference. The HHS before surgery in the traditional surgery group was (63.8±3.2) points, and (84.6±3.4) points at the last follow-up,while the preoperative HHS of the robot-assisted surgery group was (65.5±3.5) points, and (85.9±3.1) points at the last follow-up. The HHS at the last follow-up of the two groups were significantly different from those before the operation, but there was no difference between the two groups. The preoperative VAS of the traditional surgery group was (4.8±0.8) points, and (1.7±1.2) points at the last follow-up. The preoperative VAS of the robot-assisted surgery group was (5.0±0.7) points, and (0.9±0.7) points at the last follow-up. At the last follow-up of the two groups, there were significant differences in VAS, and significant difference between the two groups was also detected.Conclusion: Core decompression combined with bone grafting have a definite effect in the treatment of femoral head necrosis at early stage. Compared with traditional surgery, robot-assisted surgery can achieve better short-term results and head preservation rate. Trial registration: the research has been registered in China National Medical Research Registration and Filing System


2021 ◽  
Vol 8 ◽  
Author(s):  
Kaiyi Pang ◽  
Shujie Wang ◽  
Meng Li ◽  
Zhenlei Zhou

Objectives: In this study, the influence of methylprednisolone (MP) and 3-methyladenine (3-MA) on chondrocyte autophagy and bone quality were determined to investigate the mechanisms of femoral head necrosis in broilers.Methods: Chickens were divided into four groups: control, MP, 3-MA, and 3-MA+MP groups. Blood and bone samples were collected for biochemistry assay and bone quality determination. Cartilage was separated from the femoral head for histopathological analysis and gene expression detection.Results: The results indicated that MP treatment significantly affected blood levels of alkaline phosphatase, high-density lipoprotein, calcium, phosphorus, bone alkaline phosphatase, and osteocalcin in broilers. Additionally, MP treatment significantly increased blood levels of cholesterol, low-density lipoprotein, triglyceride, carboxy-terminal telopeptide of type-I collagen, and tartrate-resistant acid phosphatase 5. MP treatment also significantly decreased the levels of bone parameters compared with these values in controls, inhibited the expression of collagen-2, aggrecan, and mammalian target of rapamycin, and increased the expression of beclin1 and microtubule-associated protein 1 light chain 3, hypoxia-inducible factor 1 alpha, phosphoinositide 3-kinase, protein kinase B and autophagy-related gene 5 of the femoral head. Furthermore, following co-treatment with 3-MA and MP, 3-MA mitigated the effects of MP.Conclusions: Our findings demonstrated that autophagy may be involved in the pathogenesis of femoral head necrosis induced by MP in broilers, and this study provides new treatment and prevention ideas for femoral head necrosis caused by glucocorticoids.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhichao Gao ◽  
Mei Wang ◽  
Baojie Shen ◽  
Xiaodong Chu ◽  
Di Ruan

AbstractA femoral neck fracture is currently one of the most common types of fracture in clinical practice. The incidence continues to increase due to traffic accidents, trauma, and osteoporosis. This research includes a biomechanical study and a clinical retrospective study. In the biomechanical studies, three groups’ effects (Control Group: 3CCS, DHS group, and study Group: 3CCS + mFNSS group) were compared by vertical compression tests, torsion tests, and fatigue tests. All the data were collected and analyzed. We subsequently performed a retrospective analysis of 131 patients with femoral neck fractures. The operative time, intraoperative blood loss, quality of postoperative fracture reduction, and follow-up observation of fracture healing, screw retreatment rates and fixation failure rates, as well as femoral head necrosis rates and hip function in two groups with 3CCS and 3CCS + mFNSS were compared. By the biomechanical study, we found that 3CCS + Mfnss group were biomechanically superior to 3CCS group and superior to the DHS group in terms of resistance to torsion. However, it was less effective than the DHS group in compressive strength and fatigue resistance. In terms of clinical application, 3CCS + mFNSS group was found to have lower screw retreatment rates and femoral head necrosis rates, and to have better fracture healing rates than group with 3CCS, indicating that medial support screws can effectively resist the vertical shear forces of fracture ends and promote the stability and healing of fracture ends, as well as to reduce the incidence of postoperative complications.


2021 ◽  
Author(s):  
Zhen‐Qi Fan ◽  
Shu‐Cai Bai ◽  
Qian Xu ◽  
Zhi‐Jun Li ◽  
Wen‐Hao Cui ◽  
...  

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