1
|
Sun S, Li D, Wang Q, Kang P. Comparison of the Efficacy of Different Combined Therapies Based on Modified Core Decompression for the Treatment of Early-stage Nontraumatic Osteonecrosis of the Femoral Head: A Retrospective Clinical Study. Orthop Surg 2024; 16:1912-1919. [PMID: 38858808 PMCID: PMC11293917 DOI: 10.1111/os.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE Osteonecrosis of the femoral head (ONFH) is a severe orthopedic disease, which may cause severe hip dysfunction in later stage. Therefore, it is necessary to treat nontraumatic ONFH during the early stages. The aim of this study was to evaluate the clinical efficacy and survival rates of different combined therapies based on modified core decompression (CD) for early-stage nontraumatic ONFH. METHODS This retrospective cohort study assessed 397 hips with ONFH who underwent different combined therapies based on modified CD in our institution between January 2010 and December 2017. Patients were classified into six groups based on treatment modalities, and were followed up at 1 year and 5 years postoperatively. Clinical outcomes, including Harris hip score (HHS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC), were compared to evaluate the hip function and quick rehabilitation effect. Radiographic progression of ONFH and the incidence of total hip arthroplasty were analyzed to evaluate the survival rate of ONFH postoperatively. Statistical analyses were mainly performed with Kruskal-Wallis test, chi-square test and Kaplan-Meier method. RESULTS HHS increased significantly in all groups but showed no significant differences among the six groups in the first years. The nonvascularized allogeneic fibula with bone grafting (NVAF + BG) and percutaneous femoral neck-head fenestration with bone grafting via the direct anterior approach (DAA + BG) groups had significantly higher HHS (p = 0.010; p = 0.025) and WOMAC function score (p < 0.001; p = 0.012) than the CD group 5 years postoperatively. Compared with the CD group, all the other groups showed statistically significant differences in radiographic progression (p < 0.001) and a higher survival rate with no significant difference (p = 0.569). CONCLUSION Our study demonstrates the potential use of NVAF + BG and DAA + BG, may serve as a promising combined therapy for the treatment of early-stage nontraumatic ONFH.
Collapse
Affiliation(s)
- Shuo Sun
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Donghai Li
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Qin Wang
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| | - Pengde Kang
- Department of Orthopedics, Orthopedic Research Institute, West China HospitalSichuan UniversityChengduChina
| |
Collapse
|
2
|
Prasad KSRK. CORR Insights®: Is There an Association Between Femoral Head Collapse and Acetabular Coverage in Patients With Osteonecrosis? Clin Orthop Relat Res 2023; 481:60-62. [PMID: 36441115 PMCID: PMC9750567 DOI: 10.1097/corr.0000000000002501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 11/29/2022]
|
3
|
Liu M, Martin-Gomez A, Oni JK, Mears SC, Armand M. Towards Visualizing Early-stage Osteonecrosis using Intraoperative Imaging Modalities. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING. IMAGING & VISUALIZATION 2022; 11:1234-1242. [PMID: 38179232 PMCID: PMC10766436 DOI: 10.1080/21681163.2022.2157329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022]
Abstract
Osteonecrosis of the Femoral Head (ONFH) is a progressive disease characterized by the death of bone cells due to the loss of blood supply. Early detection and treatment of this disease are vital in avoiding Total Hip Replacement. Early stages of ONFH can be diagnosed using Magnetic Resonance Imaging (MRI), commonly used intra-operative imaging modalities such as fluoroscopy frequently fail to depict the lesion. Therefore, increasing the difficulty of intra-operative localization of osteonecrosis. This work introduces a novel framework that enables the localization of necrotic lesions in Computed Tomography (CT) as a step toward localizing and visualizing necrotic lesions in intra-operative images. The proposed framework uses Deep Learning algorithms to enable automatic segmentation of femur, pelvis, and necrotic lesions in MRI. An additional step performs semi-automatic segmentation of these anatomies, excluding the necrotic lesions, in CT. A final step performs pairwise registration of the corresponding anatomies, allowing for the localization and visualization of the necrosis in CT. To investigate the feasibility of integrating the proposed framework in the surgical workflow, we conducted experiments on MRIs and CTs containing early-stage ONFH. Our results indicate that the proposed framework is able to segment the anatomical structures of interest and accurately register the femurs and pelvis of the corresponding volumes, allowing for the visualization and localization of the ONFH in CT and generated X-rays, which could enable intra-operative visualization of the necrotic lesions for surgical procedures such as core decompression of the femur.
Collapse
Affiliation(s)
- Mingxu Liu
- Biomechanical- and Image-Guided Surgical Systems (BIGSS), Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD, USA
| | - Alejandro Martin-Gomez
- Biomechanical- and Image-Guided Surgical Systems (BIGSS), Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD, USA
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
| | - Julius K Oni
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Simon C Mears
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, AR, USA
| | - Mehran Armand
- Biomechanical- and Image-Guided Surgical Systems (BIGSS), Laboratory for Computational Sensing and Robotics, Johns Hopkins University, Baltimore, MD, USA
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD, USA
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
4
|
Li B, Yu L, Huang Z, Liang Y, Li G, Zhao Y. A novel device for treatment of osteonecrosis of femoral head: Feasibility and preliminary efficacy of animal study. J Orthop Translat 2021; 31:20-25. [PMID: 34760621 PMCID: PMC8550985 DOI: 10.1016/j.jot.2021.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/22/2021] [Accepted: 09/13/2021] [Indexed: 12/29/2022] Open
Abstract
Background Interruption of blood supply will lead to necrosis of body tissues, such as osteonecrosis of femoral head (ONFH). Vascularization has always been regarded as one of the biggest challenges in tissue engineering. In the current study, a novel device was proposed to reconstruct blood supply of necrotic femoral head. Methods Cryo-insult with liquid nitrogen method was adopted to establish the ONFH model. In experimental group, a novel scaffold carrying vascular bundle was implanted into the necrotic femoral head after decompression and the transplanted vascular bundles were anastomosed with the existing blood vessels around the hip. In control group, a traditional porous scaffold was inserted alone without vessels. Feasibility of this strategy was verified by animal experiments. Micro-CT analysis and histological evaluation were performed to investigate its preliminary efficacy. Results Feasibility of this innovative treatment strategy had been successfully verified in animal experiments. In the area of necrosis repair, more bone tissue grew into the scaffold in experimental group than the control group evaluated by Micro-CT (three months: 29.66% VS 20.35%, P<0.05; six months: 30.47% VS 25.10%, P<0.05) and histological analysis (24.71% VS 16.45%, P<0.05 at three months; 31.01% VS 20.60%, P<0.05 at six months). Implanted vascular bundles had the potential to branch out many branches in the osteonecrosis repair area to facilitate blood supply reconstruction and bone repair. Conclusions This study proposed a novel device with clinical application prospects in the treatment of ONFH. It has the potential to provide new possibilities for rebuilding the blood supply of femoral head and repairing osteonecrosis. Translational potential statement The novel device proposed in this study has the potential to be applied to the treatment of early femoral head necrosis.
Collapse
Affiliation(s)
- Bo Li
- Department of Orthopaedics & Traumatology, Beijing Jishuitan Hospital, Beijing, China
| | - Lingjia Yu
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenfei Huang
- Department of Orthopaedic Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yongxin Liang
- Department of Hand Surgery, Yuquan Hospital of Tsinghua University, Beijing, China
| | - Guangping Li
- Laboratory of Bone Tissue Engineering, Beijing Laboratory of Biomedical Materials, Beijing Research Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing, China
| | - Yu Zhao
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
5
|
Implantation of autologous Expanded Mesenchymal Stromal Cells in Hip Osteonecrosis through Percutaneous Forage: Evaluation of the Operative Technique. J Clin Med 2021; 10:jcm10040743. [PMID: 33673388 PMCID: PMC7918570 DOI: 10.3390/jcm10040743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Bone forage to treat early osteonecrosis of the femoral head (ONFH) has evolved as the channel to percutaneously deliver cell therapy into the femoral head. However, its efficacy is variable and the drivers towards higher efficacy are currently unknown. The aim of this study was to evaluate the forage technique and correlate it with the efficacy to heal ONFH in a multicentric, multinational clinical trial to implant autologous mesenchymal stromal cells expanded from bone marrow (BM-hMSCs). Methods: In the context of EudraCT 2012-002010-39, patients with small and medium-sized (mean volume = 13.3%, range: 5.4 to 32.2) ONFH stage II (Ficat, ARCO, Steinberg) C1 and C2 (Japanese Investigation Committee (JIC)) were treated with percutaneous forage and implantation of 140 million BM-hMSCs in a standardized manner. Postoperative hip radiographs (AP—anteroposterior and lateral), and MRI sections (coronal and transverse) were retrospectively evaluated in 22 patients to assess the femoral head drilling orientation in both planes, and its relation to the necrotic area. Results: Treatment efficacy was similar in C1 and C2 (coronal plane) and in anterior to posterior (transverse plane) osteonecrotic lesions. The drill crossed the sclerotic rim in all cases. The forage was placed slightly valgus, at 139.3 ± 8.4 grades (range, 125.5–159.3) with higher dispersion (f = 2.6; p = 0.034) than the anatomical cervicodiaphyseal angle. Bonferroni’s correlation between both angles was 0.50 (p = 0.028). More failures were seen with a varus drill positioning, aiming at the central area of the femoral head, outside the weight-bearing area (WBA) (p = 0.049). In the transverse plane, the anterior positioning of the drill did not result in better outcomes (p = 0.477). Conclusion: The forage drilling to deliver cells should be positioned within the WBA in the coronal plane, avoiding varus positioning, and central to anterior in the transverse plane. The efficacy of delivered MSCs to regenerate bone in ONFH could be influenced by the drilling direction. Standardization of this surgical technique is desirable.
Collapse
|
6
|
Mont MA, Salem HS, Piuzzi NS, Goodman SB, Jones LC. Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today?: A 5-Year Update. J Bone Joint Surg Am 2020; 102:1084-1099. [PMID: 32282421 PMCID: PMC7508290 DOI: 10.2106/jbjs.19.01271] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➢. Clinicians should exercise a high level of suspicion in at-risk patients (those who use corticosteroids, consume excessive alcohol, have sickle cell disease, etc.) in order to diagnose osteonecrosis of the femoral head in its earliest stage. ➢. Nonoperative treatment modalities have generally been ineffective at halting progression. Thus, nonoperative treatment is not appropriate in early stages when one is attempting to preserve the native joint, except potentially on rare occasions for small-sized, medially located lesions, which may heal without surgery. ➢. Joint-preserving procedures should be attempted in early-stage lesions to save the femoral head. ➢. Cell-based augmentation of joint-preserving procedures continues to show promising results, and thus should be considered as an ancillary treatment method that may improve clinical outcomes. ➢. The outcomes of total hip arthroplasty in the setting of osteonecrosis are excellent, with results similar to those in patients who have an underlying diagnosis of osteoarthritis.
Collapse
Affiliation(s)
- Michael A. Mont
- Lenox Hill Hospital, New York, NY,Cleveland Clinic, Cleveland, Ohio,Email address for M.A. Mont:
| | | | | | | | - Lynne C. Jones
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
7
|
Lin D, Wang L, Yu Z, Luo D, Zhang X, Lian K. Lantern-shaped screw loaded with autologous bone for treating osteonecrosis of the femoral head. BMC Musculoskelet Disord 2018; 19:318. [PMID: 30185196 PMCID: PMC6123930 DOI: 10.1186/s12891-018-2243-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/24/2018] [Indexed: 12/23/2022] Open
Abstract
Background Treatment for osteonecrosis of the femoral head (ONFH) in young individuals remains controversial. We developed a lantern-shaped screw, which was designed to provide mechanical support for the femoral head to prevent its collapse, for the treatment of ONFH. The purpose of this study was to investigate the efficacy and safety of the lantern-shaped screw loaded with autologous bone for the treatment of pre-collapse stages of ONFH. Methods Thirty-two patients were randomly divided into two groups: the lantern-shaped screw group (core decompression and lantern-shaped screw loaded with autogenous bone) and the control group (core decompression and autogenous bone graft). During 36 months follow-up after surgery, treatment results in patients were assessed by X-ray and computed tomography (CT) scanning as well as functional recovery Harris hip score (HHS). Results Successful clinical results were achieved in 15 of 16 hips (94%) in the lantern-shaped screw group compared with 10 of 16 hips (63%) in the control group (p = 0.0325). Successful radiological results were achieved in 14 of 16 hips (88%) in the lantern-shaped screw group compared with 8 of 16 hips (50%) in the control group (P = 0.0221). Conclusion The lantern-shaped screw loaded with autologous bone for the treatment of pre-collapse stages of ONFH is effective and results in preventing progression of ONFH and reducing the risk of femoral head collapse. Trial registration The trial registration number: ChiCTR-TRC-13004078 (retrospectively registered at 2013-11-28).
Collapse
Affiliation(s)
- Dasheng Lin
- Orthopaedic Center of People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, 363000, China. .,Department of Surgery, Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-University (LMU), 80336, Munich, Germany.
| | - Lei Wang
- Orthopaedic Center of People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, 363000, China
| | - Zhaoliang Yu
- Weigao Orthopaedic Device Co., Ltd, Weihai, 264200, China
| | - Deqing Luo
- Orthopaedic Center of People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, 363000, China
| | - Xigui Zhang
- Double Engine Medical Material Co., Ltd, Xiamen, 361000, China
| | - Kejian Lian
- Orthopaedic Center of People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, 363000, China
| |
Collapse
|
8
|
Zhang Q, Yang F, Chen Y, Wang H, Chen D, He W, Chen P. Chinese herbal medicine formulas as adjuvant therapy for osteonecrosis of the femoral head: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e12196. [PMID: 30200126 PMCID: PMC6133442 DOI: 10.1097/md.0000000000012196] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Osteonecrosis of femoral head (ONFH) is a disabling clinical entity affecting mainly young adults. Although Chinese Herbal Medicine (CHM) has been widely used as an adjunct therapy for ONFH in China, its effectiveness is not well defined. The purpose of this systematic review is to assess the effectiveness of CHM as an adjunct therapy to core decompression (CD) for patients with ONFH. METHODS A systematic literature search was conducted in 10 electronic databases. Randomized controlled trials involving CHM and CD for ONFH were included. Two authors independently assessed the studies for inclusion and extracted the data. A meta-analysis was conducted to estimate the safety and efficacy of CHM as an adjunct therapy. RESULTS Twenty-three randomized controlled trials with 1815 participants were included. The formulas used in these studies were different and we only combined data of studies observing the same formulas. Patients treated with CHM additionally exhibited a better TER (total effective rate) compared with CD alone in different degree, with the risk ratio (RR) varies from 1.09 to 1.09. The Harris score and radiographic effective rate indicate a similar result, with the medicine (MD) varies from 17.35 to 14.94 and RR 1.40 to 1.27. The risk of side-effect was barely reported except only 2 study record that no complications were observed. CONCLUSION This systematic review indicated that CHM as adjunctive therapy may improve the effectiveness of CD. However, a firm conclusion could not be reached because of overall high risk of bias in most domains. Further studies of higher quality are required, and other benefits of CHM remain to be determined.
Collapse
Affiliation(s)
| | - Fan Yang
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | | | - Delong Chen
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
| | - Wei He
- First Affiliated Hospital
| | | |
Collapse
|
9
|
Qual o papel da descompressão simples em estágios precoces na osteonecrose da cabeça femoral? Avaliação do resultado cirúrgico por meio de escore funcional e acompanhamento radiológico. Rev Bras Ortop 2018. [DOI: 10.1016/j.rbo.2017.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
|
10
|
Miyahara HDS, Rosa BB, Hirata FY, Gurgel HDMC, Ejnisman L, Vicente JRN. What is the role of core decompression in the early stages of osteonecrosis of the femoral head? Evaluation of the surgical result by functional score and radiological follow-up. Rev Bras Ortop 2018; 53:537-542. [PMID: 30245991 PMCID: PMC6147800 DOI: 10.1016/j.rboe.2018.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/20/2017] [Indexed: 12/16/2022] Open
Abstract
Objectives This study is aimed at evaluating whether core decompression of the femoral head in the early stages of femoral head osteonecrosis improves patients’ subjective perception of pain and avoids the progression of the disease to a femoral head collapse and a final indication of total hip arthroplasty. Methods Eighteen patients (30 hips) in the early stages of the disease (Ficat and Arlet 1 and 2A) were evaluated through clinical, radiological, risk factor maintenance, and by the functional Merle D’Aubigné, and Postel score before and after core decompression of the femoral head. Results There was an improvement of symptoms up to the sixth month in 83.3% of the hips evaluated through the Merle D’Aubigné and Postel score. However, 73.3% of the cases evolved with femoral head collapse, and in 50%, total hip arthroplasty was indicated regardless of whether or not the risk factors were maintained. Conclusions Core decompression of the femoral head improves patients’ pain early in the initial stages of the pathology. However, it does not alter the prognosis and the ultimate indication of total hip arthroplasty in the final stages of the disease.
Collapse
Affiliation(s)
- Helder de Souza Miyahara
- Instituto de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Berbert Rosa
- Instituto de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fabio Yuiti Hirata
- Instituto de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Leandro Ejnisman
- Instituto de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | |
Collapse
|
11
|
Ahrar K, Sabir SH, Yevich SM, Sheth RA, Ahrar JU, Tam AL, Stafford JR. MRI-Guided Interventions in Musculoskeletal System. Top Magn Reson Imaging 2018; 27:129-139. [PMID: 29870465 DOI: 10.1097/rmr.0000000000000151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Image-guided interventions in the musculoskeletal system require accurate detection and characterization of lesions involving bone and soft tissues. Magnetic resonance imaging (MRI) has superior soft tissue contrast resolution particularly in bone and soft tissues where computed tomography and ultrasonography have significant limitations. In addition, the multiplanar imaging capabilities of MRI facilitate targeting lesions and tracking interventional devices. Although conventional diagnostic MRI sequences suffer from motion sensitivity and prolonged imaging time, recently developed fast imaging sequences allow for rapid acquisition of high-quality images, rendering MRI more suitable for image-guided interventions. Although computed tomography and ultrasonography still dominate the spectrum of image-guided interventions in the musculoskeletal system, many MRI-guided procedures have been developed and are well established in routine clinical work. In addition, new techniques and novel MRI-guided applications are being developed to address complex clinical problems in a minimally invasive fashion.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Jason R Stafford
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
12
|
Li Z, Yang B, Weng X, Tse G, Chan MTV, Wu WKK. Emerging roles of MicroRNAs in osteonecrosis of the femoral head. Cell Prolif 2017; 51. [PMID: 29131454 DOI: 10.1111/cpr.12405] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 08/28/2017] [Indexed: 12/14/2022] Open
Abstract
Osteonecrosis of the femoral head (ONFH) is one of the most common orthopaedic diseases. The exact pathogenic mechanism of ONFH is still unknown. MicroRNAs (miRNAs) are a class of non-coding RNAs that negatively modulate gene expression at post-transcriptional level. An increasing number of studies have shown that miRNAs play crucial roles in different physiological processes, including development, cell proliferation, differentiation and metabolism. Recently, multiple studies demonstrated that miRNAs are involved in the pathogenesis of ONFH. In this review, we summarize dysregulated miRNAs and their functions in ONFH. Furthermore, we discuss their potential clinical applications for diagnosis and treatment of ONFH.
Collapse
Affiliation(s)
- Zheng Li
- Department of Orthopedics Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Yang
- Department of Orthopedics Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xisheng Weng
- Department of Orthopedics Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gary Tse
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Matthew T V Chan
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong
| | - William Ka Kei Wu
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease and LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
13
|
Cazzato RL, Garnon J, Ramamurthy N, Tsoumakidou G, Caudrelier J, Thenint MA, Rao P, Koch G, Gangi A. Percutaneous MR-Guided Cryoablation of Morton’s Neuroma: Rationale and Technical Details After the First 20 Patients. Cardiovasc Intervent Radiol 2016; 39:1491-8. [DOI: 10.1007/s00270-016-1365-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023]
|
14
|
Manenti G, Altobelli S, Pugliese L, Tarantino U. The role of imaging in diagnosis and management of femoral head avascular necrosis. ACTA ACUST UNITED AC 2016; 12:31-8. [PMID: 27134630 DOI: 10.11138/ccmbm/2015.12.3s.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this paper is to critically review the literature documenting the imaging approach in adult Femoral Head Avascular Necrosis (FHAVN). For this purpose we described and evaluated different radiological techniques, such as X-ray, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Nuclear Medicine. Plain films are considered the first line imaging technique due to its ability to depict femoral head morphological changes, to its low costs and high availability. CT is not a routinely performed technique, but is useful to rule out the presence of a subchondral fracture when MRI is doubtful or contraindicated. MRI is unanimously considered the gold standard technique in the early stages, being capable to detect bone marrow changes such as edema and sclerosis. It may be useful also to guide treatment and, as CT, it is a validated technique in follow-up of patients with FHAVN. Nuclear medicine imaging is mostly applied in post-operative period to detect graft viability or infective complications. More advanced techniques may be useful in particular conditions but still need to be validated; thus new research trials are desirable. In conclusion, X-ray examination is the first line approach, but lacks of sensitivity in early stage whereas MRI is indicated. CT easily depicts late stage deformation and may decrease MRI false positive results in detecting the subchondral fracture. However, the role of both Nuclear Medicine Imaging and advanced MR techniques in FHAVN still need to be investigated.
Collapse
Affiliation(s)
- Guglielmo Manenti
- Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy
| | - Simone Altobelli
- Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy
| | - Luca Pugliese
- Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy
| | - Umberto Tarantino
- Department of Orthopaedics and Traumatology, University of Rome Tor Vergata, "Policlinico Tor Vergata" Foundation, Rome, Italy
| |
Collapse
|