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Shoji T, Shozen H, Ueki S, Kaneta H, Yaunaga Y, Adachi N. Evaluation of the long-term patient-reported outcomes after hip arthroplasty or joint preserving with Sugioka femoral osteotomy in patients with femoral head osteonecrosis. INTERNATIONAL ORTHOPAEDICS 2024; 48:1201-1208. [PMID: 38376531 PMCID: PMC11001741 DOI: 10.1007/s00264-024-06118-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE This study retrospectively evaluated long-term clinical outcomes and patient-reported outcome measures (PROMs) in patients with osteonecrosis of the femoral head (ONFH) who underwent transtrochanteric rotational osteotomy (TRO), curved varus osteotomy (CVO), and total hip arthroplasty (THA). METHODS We retrospectively reviewed the 109 hips in 96 patients (46 men, 50 women) who underwent CVO, TRO, or THA for ONFH treatment. The mean follow-up period for the TRO, CVO, and THA groups was 14.8, 11.5, and 13.3 years, respectively. RESULTS The THA conversion rate of the TRO patients was significantly higher than that of the patients with CVO, and the final clinical scores in the patients with TRO did not improve compared with preoperative scores. Postoperative PROMs showed that the total and pain scores of the patients with THA were significantly higher than those of patients with TRO and CVO, while the PROM score did not change between patients with TRO and CVO. The analysis further showed that the preoperative type C2, stage 3A, or postoperative type C1 and C2 were significant predictors of decreased final PROM scores. CONCLUSION This study found that CVO and THA are clinically effective treatments for ONFH, with significant improvements compared with preoperative scores. However, THA was associated with significantly higher PROMs and pain scores than those of CVO and TRO in long-term follow-up. Furthermore, our results suggest that postoperative PROMs depend mainly on the preoperative level of collapse and postoperative transposed intact ratio of the articular surface of the femoral head.
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Affiliation(s)
- Takeshi Shoji
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
| | - Hideki Shozen
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Shinichi Ueki
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hiroki Kaneta
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yuji Yaunaga
- Department of Orthopaedic Surgery, Hiroshima Prefectural Rehabilitation Center, 295-3 Taguchi, Saijo-Town, Higashi-Hiroshima, 739-0036, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
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Kuroda Y, Kawai T, Okuzu Y, Morita Y, Matsuda S. Investigational regenerative medicine for non-traumatic osteonecrosis of the femoral head: a survey of registered clinical trials. Expert Opin Investig Drugs 2024; 33:405-414. [PMID: 38431280 DOI: 10.1080/13543784.2024.2326622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Osteonecrosis of the femoral head (ONFH) is a refractory disease requiring joint replacement in young patients. Regenerative therapies have been developed. AREAS COVERED This study surveyed clinical trials on regenerative medicine for ONFH. We extracted clinical trials on non-traumatic ONFH from the websites of five publicly available major registries (EuropeanUnion Clinical Trials Register ([EU-CTR],ClinicalTrials.gov, Chinese ClinicalTrial Registry [ChiCTR], University Hospital Medical InformationNetwork - Clinical Trial Registry [UMIN-CTR] and Australian New Zealand Clinical Trials Registry [ANZCTR]).The trials were classified into six categories based on purpose: surgical treatment, non-drug conservative treatment, conservative drug treatment, therapeutic strategy, diagnosis and pathogenesis, and regenerative therapy.) We extracted 169 clinical trials on ONFH. Of these, 37 were on regenerative medicine, including 29 on cell therapy. Surgical treatment was the most common treatment, followed by regenerative therapy.There were 9 clinical trials registered in the EU-CTR, with 5 on regenerative medicine; 79 trials registered on ClinicalTrials.gov, with 24 on regenerativemedicine; 54 trials registered in the ChiCTR, with 6 on regenerative medicine. EXPERT OPINION The focus of the joint-preserving surgery has shifted to regenerative therapy based on using cell therapy in early-stage ONFH. The global standardisation of regenerative therapy is still ongoing.
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Affiliation(s)
- Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Toshiyuki Kawai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Yaichiro Okuzu
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Yugo Morita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
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Zhao G, Liu Y, Zheng Y, An M, Zhang J, Zhang J, Li Z, Chunbao L. Exploring molecular mechanisms of intra-articular changes in osteonecrosis of femoral head using DIA proteomics and bioinformatics. J Orthop Surg Res 2024; 19:13. [PMID: 38169408 PMCID: PMC10763026 DOI: 10.1186/s13018-023-04464-3] [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: 08/31/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE This study is aimed to delve into the crucial proteins associated with hormonal osteonecrosis of the femoral head (ONFH) and its intra-articular lesions through data-independent acquisition (DIA) proteomics and bioinformatics analysis. METHODS We randomly selected samples from eligible ONFH patients and collected samples from the necrotic area of the femoral head and load-bearing cartilage. The control group comprised specimens from the same location in patients with femoral neck fractures. With DIA proteomics, we quantitatively and qualitatively tested both groups and analyzed the differentially expressed proteins (DEPs) between groups. Additionally, we enriched the analysis of DEP functions using gene ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways and verified the key proteins in ONFH through Western blot. RESULTS Proteomics experiment uncovered 937 common DEPs (422 upregulated and 515 downregulated) between the two groups. These DEPs mainly participate in biological processes such as hidden attributes, catalytic activity, molecular function regulators, and structural molecule activity, and in pathways such as starch and sucrose metabolism, ECM-receptor interaction, PI3K-Akt signaling, complement and coagulation cascades, IL-17 signaling, phagosome, transcriptional misregulation in cancers, and focal adhesion. Through protein-protein interaction network target gene analysis and Western blot validation, we identified C3, MMP9, APOE, MPO, LCN2, ELANE, HPX, LTF, and THBS1 as key proteins in ONFH. CONCLUSIONS With DIA proteomics and bioinformatics analysis, this study reveals the molecular mechanisms of intra-articular lesions in ONFH. A correlation in the necrotic area and load-bearing cartilage of ONFH at ARCO stages IIIB-IV as well as potential key regulatory proteins was identified. These findings will help more deeply understand the pathogenesis of ONFH and may provide important clues for seeking more effective treatment strategies.
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Affiliation(s)
- Gang Zhao
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China
- Department of Orthopaedics, Chinese PLA 984 Hospital, Beijing, 100029, China
- Medical school of Chinese PLA, Beijing, 100853, China
| | - Yujie Liu
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China
| | - Yongjun Zheng
- Department of Orthopaedics, Chinese PLA 984 Hospital, Beijing, 100029, China
| | - Mingyang An
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China
| | - Jia Zhang
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China
| | - Jing Zhang
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China
| | - Zhongli Li
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China
| | - Li Chunbao
- Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing, 100048, China.
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Imamura A, Kuroyanagi G, Usami T, Sato T, Horiba M, Sakai H, Takahashi A, Ueki Y, Matsukawa N, Murakami H. Levodopa-Carbidopa Intestinal Gel Injection for Patient with Severe Parkinson's Disease Followed by Total Hip Arthroplasty: A Case Report and Literature Review. Orthop Surg 2023; 15:2993-2999. [PMID: 37712322 PMCID: PMC10622286 DOI: 10.1111/os.13879] [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: 12/06/2022] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Patients with Parkinson's disease have a high dislocation rate after total hip arthroplasty (THA). This study describes a case with severe Parkinson's disease who developed rapidly destructive coxarthrosis (RDC) and underwent THA using a dual mobility cup after a levodopa-carbidopa intestinal gel (LCIG) infusion. CASE PRESENTATION The patient is a 59-year-old female with a ten-year history of Parkinson's disease, which was first treated with oral levodopa. The patient developed RDC of the right hip joint. However, THA was difficult owing to Parkinson's disease and its treatment side effects, such as wearing-off, dyskinesia, and freezing of the gait, Thus, LCIG was initiated, and improvement in wearing-off and dyskinesia was observed. Two months after the LCIG therapy, the disease was controlled well. THA was subsequently performed using a dual mobility cup to prevent postoperative dislocation. Postoperatively, LCIG therapy was continuously administered to carefully manage the disease, which was controlled well with no increase in wearing-off and dyskinesia after surgery. At 1 year after surgery, the walking speed, stride length, and the Harris hip score improved compared to preoperatively. The UPDRS III motor score improved to eight without signs of wearing-off or dyskinesia. The Hoehn-Yahr scale was II in the "on" period and remained unchanged 1 year after surgery. The patient could walk without a cane and had satisfactory functional outcomes. CONCLUSION This case proved that LCIG treatment performed preoperatively, followed by THA using a dual mobility cup, and strict management of Parkinson's disease could result in a satisfactory clinical course without recurrence of wearing-off and dyskinesia. Similar procedures may benefit other patients with Parkinson's disease who have previously been deemed unsuitable for THA.
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Affiliation(s)
- Atsushi Imamura
- Department of Orthopaedic SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Gen Kuroyanagi
- Department of Orthopaedic SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
- Department of Rehabilitation MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Takuya Usami
- Department of Orthopaedic SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
- Department of Orthopaedic SurgeryNagoya City University East Medical CenterNagoyaJapan
| | - Toyohiro Sato
- Department of Neurology and NeuroscienceNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Mitsuya Horiba
- Department of Rehabilitation MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Hiroaki Sakai
- Department of Orthopaedic SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Ayaka Takahashi
- Department of Orthopaedic SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yoshino Ueki
- Department of Rehabilitation MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Noriyuki Matsukawa
- Department of Neurology and NeuroscienceNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Hideki Murakami
- Department of Orthopaedic SurgeryNagoya City University Graduate School of Medical SciencesNagoyaJapan
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Park SJ, Kim BG. Effects of exercise therapy on the balance and gait after total hip arthroplasty: a systematic review and meta-analysis. J Exerc Rehabil 2023; 19:190-197. [PMID: 37662528 PMCID: PMC10468294 DOI: 10.12965/jer.2346290.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 09/05/2023] Open
Abstract
The situation is such that there is a lack of research analyzing the effect of exercise therapy during the rehabilitation period of patients after total hip arthroplasty (THA). Therefore, the purpose of this systematic review and meta-analysis is to analyze the effects of exercise therapy on the balance and gait of patients after THA. The studies selected for this study were based on the PICO as follows: P (Patient)-patients after THA, I (Intervention)-exercise therapy, C (Comparison)-control and other therapy groups, O (Outcome)-balance and gait. Additional criteria for this study were study design (randomized controlled study), language (English), publication status (journal), and the year of publication were not limited. Eleven studies were included. The effects of exercise therapy on balance and gait in patients after THA were significantly different. Balance: standardized mean difference (SMD), 0.51; 95% confidence intervals (CI), 0.24-0.78; I2=22%. Gait: SMD, 0.39; 95% CI, 0.01-0.76; I2=66%. Rehabilitation specialists recommend that exercise therapy be included in rehabilitation programs to improve balance and gait in patients after THA. Further research is needed in the future, including more studies and a network meta-analysis that analyzes the effect size of each exercise therapy.
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Affiliation(s)
- Se-Ju Park
- Department of Rehabilitation, Songwon University, Gwangju,
Korea
| | - Byeong-Geun Kim
- Department of Rehabilitation, Songwon University, Gwangju,
Korea
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Fan Y, Liu X, Zhong Y, Zhang J, Liu Y, Fang H, He W, Zhou C, Chen Z. Evaluation of the predictive values of collapse and necrotic lesion boundary for osteonecrosis of the femoral head prognosis. Front Endocrinol (Lausanne) 2023; 14:1137786. [PMID: 36992802 PMCID: PMC10040974 DOI: 10.3389/fendo.2023.1137786] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE Osteonecrosis of the femoral head (ONFH) is a disabling and intractable orthopedic disease largely affecting young and middle-aged groups. Current standard of treatment relies on the collapse of femoral head as a predictor for prognosis. However, a wide range of variability in repair potentials is observed in patients with femoral head collapse. Therefore, the present study aimed to evaluate the accuracy of femoral head collapse as a predictor and to propose the necrotic lesion boundary as a novel yet reliable measure for ONFH prognosis. METHODS A retrospective cross-sectional study was conducted at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, 203 hips with ONFH from 134 patients were included. The occurrences and progression of femoral head collapse were recorded. Necrosis lesion boundary was quantified and classified for each case based on anteroposterior view intact ratio (APIR) and the frog-leg view intact ratio (FLIR) as independent variables. Dependent variables were defined as progressive collapse or terminal collapse for Association Research Circulation Osseous (ARCO) stage II and III respectively. Logistic regression analysis, Receiver Operating Characteristic (ROC) curve and Kaplan-Meier (K-M) survival analysis was performed and results were interpreted. RESULTS Out of the 106 hips in ARCO stage II, 31 hips collapsed with further progression, while 75 hips had no collapse or collapse with repair of the necrotic areas. Out of the 97 hips in ARCO stage IIIA, the collapse continued to progress in 58 hips while the necrotic areas were repaired in 39 hips. Logistic regression analysis demonstrated that both APIR and FLIR, were independent risk factors. Further ROC curve analysis indicated that the cutoff values of APIR and FLIR could be considered as indications for evaluating the prognosis of ONFH. Contrary to the traditional view of poor prognosis after femoral head collapse, K-M survival analysis demonstrated a high value of APIR and FLIR for ONFH prognosis. CONCLUSION The present study found that the occurrence of collapse is an oversimplified predictor for ONFH prognosis. The collapse of the femoral head in ONFH does not predict a poor prognosis. The necrosis lesion boundary has a high value in predicting ONFH prognosis and informing clinical treatment strategies.
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Affiliation(s)
- Yinuo Fan
- The Third Clinical of Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xuejie Liu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuan Zhong
- The Third Clinical of Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiahao Zhang
- The First Clinical of Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuhao Liu
- The Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hanjun Fang
- The Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wei He
- The Department of Orthopedics, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- *Correspondence: Wei He, ; Zhenqiu Chen,
| | - Chi Zhou
- The Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhenqiu Chen
- The Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- *Correspondence: Wei He, ; Zhenqiu Chen,
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Chen WH, Guo WX, Li JX, Wei QS, Li ZQ, He W. Application of protective weight-bearing in osteonecrosis of the femoral head: A systematic review and meta-analysis of randomized controlled trials and observational studies. Front Surg 2022; 9:1000073. [PMID: 36406362 PMCID: PMC9667948 DOI: 10.3389/fsurg.2022.1000073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/06/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The aim of this systematic review and meta-analysis was to estimate the efficacy and prognostic value of protective weight-bearing for ONFH. METHODS The authors searched the PubMed, EMBASE and Cochrane Library databases, up to February 25, 2022. RCTs and observational studies on conservative treatment, including the use of crutches, for skeletally mature patients with ONFH and written in English were included. Outcomes were the total hip arthroplasty (THA) rate, collapse rate, Hip Harris score (HHS) and visual analog scale (VAS) score. Cochrane Review Manager Software 5.4 and Stata 15.1 were used to perform the statistical analyses. RESULTS A total of 14 studies involving 813 patients (1,025 hips) were included in this meta-analysis. The results showed that the THA rate, collapse rate, HHS and VAS scores in the protective weight-bearing group were not significantly different from those in the surgical group. In the protective weight-bearing group, the results showed that the THA rate was 40%, 8% in ARCO stage II, 37% in ARCO stage III, and the collapse rate was 46%. The mean HHS and VAS score was 80.86 and 1.00, respectively. The HHS score at the 3-, 6-, 12-, and 24-month follow-up was 79.93, 83.94, 85.94, and 96.09 points, respectively, whereas the VAS score at the 6- and 12-month follow-up was 2.20 and 1.29, respectively. CONCLUSION Protective weight bearing could achieve satisfactory results in terms of THA rate, collapse rate, HHS and VAS scores. Protective weight-bearing allows most precollapse patients to preserve the hip but also allows postcollapse patients to delay THA or hip-preserving surgery. The effects and prognosis of protective weight-bearing in the short or mid-term are noninferior to surgical hip preservation and are a viable alternative option for osteonecrosis of the femoral head.
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Affiliation(s)
- Wen-huan Chen
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen-xuan Guo
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jian-xiong Li
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiu-shi Wei
- Department of Joint Surgery, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zi-qi Li
- Department of Joint Surgery, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei He
- Department of Joint Surgery, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,Correspondence: Wei He
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Chen W, Li J, Guo W, Gao S, Wei Q, Li Z, He W. Outcomes of surgical hip dislocation combined with bone graft for adolescents and younger adults with osteonecrosis of the femoral head: a case series and literature review. BMC Musculoskelet Disord 2022; 23:499. [PMID: 35619082 PMCID: PMC9134689 DOI: 10.1186/s12891-022-05456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Osteonecrosis of the femoral head (ONFH) may occur in the adolescent and younger adults (AYAs). Total hip arthroplasty (THA) is not the best treatment option for younger patients. Surgical hip dislocation (SHD) combined with bone graft can be used in patients at different stages to reconstruct the bone structure in the head and delay the replacement time. The purpose of this study was to evaluate the effect and potential influencing factors of this surgery for ONFH in AYA patients. Methods We conducted a literature review and a retrospective research of our own cases. The Pubmed, Cochrane Library, EMBASE and CNKI databases were searched from 1 January 2001 to 1 October 2021, for clinical studies. A retrospective case series study of 34 patients (38 hips) treated with SHD combined with bone graft was performed. Results A total of 13 studies were included and the results showed that SHD combined with bone grafts had better clinical results for patients with pre- or early post-collapse. In the case series study, we retrospectively analyzed 34 patients (38 hips), and the mean follow-up time was 40.77 ± 15.87 months. One patient died and three patients were converted to THA finally. The post-collapse degree and post-lesion size were better than those before the operation (P < 0.05). The iHOT-12 at the last follow-up was significantly higher than that before the operation (P < 0.05). There were significant differences in the results of hip Harris score (HHS), visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before the operation, 2 years after the operation and at the last follow-up, but the difference was not related to the follow-up time (P < 0.05). There were no significant differences in the final clinical score and arthritic changes among different Japanese Investigation Committee (JIC) classification, the degree of collapse and the size of the necrotic (P > 0.05). Conclusions In AYA patients, SHD combined with bone grafting is a potentially good option for hip preservation in ONFH. The differences in JIC classification, collapse degree and lesion size did not affect the final clinical function and the risk of osteoarthritis. Even for very severe cases at collapsed stage, good short-term clinical effects can still be achieved by SHD combined with bone graft. Trial registration ChiCTR2100055079.retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05456-w.
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Affiliation(s)
- Wenhuan Chen
- The Third Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Jianxiong Li
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Wenxuan Guo
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shihua Gao
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Qiushi Wei
- Department of Joint Diseases, Traumatology & Orthopedics Institute of Guangzhou University of Chinese Medicine, The Third Afliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ziqi Li
- Department of Joint Diseases, Traumatology & Orthopedics Institute of Guangzhou University of Chinese Medicine, The Third Afliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wei He
- Department of Joint Diseases, Traumatology & Orthopedics Institute of Guangzhou University of Chinese Medicine, The Third Afliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
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Liu N, Zheng C, Wang Q, Huang Z. Treatment of non-traumatic avascular necrosis of the femoral head (Review). Exp Ther Med 2022; 23:321. [PMID: 35386618 PMCID: PMC8972838 DOI: 10.3892/etm.2022.11250] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/26/2022] [Indexed: 11/06/2022] Open
Abstract
Non-traumatic osteonecrosis of the femoral head is the main cause of disability in young individuals and incurs major health care expenditure. The lifestyle changes in recent years, especially increased use of hormones and alcohol consumption, has greatly increased the incidence of femoral head necrosis. The underlying causes and risk factors of osteonecrosis of the femoral head are increasingly being elucidated, which has led to the development of novel surgical and non-surgical treatment options. Although the main goal of any treatment method is prevention and delaying the progression of disease, there is no common consensus on the most suitable method of treatment. The present review discussed the latest developments in the etiology and treatment methods for femoral head necrosis.
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Affiliation(s)
- Ning Liu
- Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | | | - Qinglong Wang
- Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Zhipeng Huang
- Department of Orthopedics, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi 710000, P.R. China
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lncRNA FGD5-AS1 Regulates Bone Marrow Stem Cell Proliferation and Apoptosis by Affecting miR-296-5p/STAT3 Axis in Steroid-Induced Osteonecrosis of the Femoral Head. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9364467. [PMID: 35190765 PMCID: PMC8858055 DOI: 10.1155/2022/9364467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 11/27/2022]
Abstract
Background Osteonecrosis of the femoral head (ONFH) is a common hip joint disease, which is more harmful and seriously affects the lives of patients. This study aims to clarify the regulatory mechanism of lncRNA FGD5-AS1 in ONFH. Methods The expression of the protein and mRNA was detected by RT-qPCR and Western blot assay. The regulatory mechanism of lncRNA FGD5-AS1 was detected by the dual-luciferase reporter assay, CCK-8 assay, and flow cytometry assay. Results Dex can inhibit cell proliferation and differentiation and induce apoptosis in hBMSCs in a dose-dependent manner. Overexpression of lncRNA FGD5-AS1 promoted cell proliferation and restrained apoptosis in Dex-treated hBMSCs. In addition, lncRNA FGD5-AS1 acts as a sponge for miR-296-5p. Also, miR-296-5p directly targets STAT3. More importantly, miR-296-5p and STAT3 can affect the function of lncRNA FGD5-AS1 in Dex-treated hBMSCs. Conclusion lncRNA FGD5-AS1 promotes cell proliferation and inhibits apoptosis in steroid-induced ONFH through acting as a sponge for miR-296-5p and upregulation of STAT3.
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Kuroda Y, Tanaka T, Miyagawa T, Hamada H, Abe H, Ito-Ihara T, Asada R, Fujimoto Y, Takahashi D, Tetsunaga T, Kaneuji A, Takagi M, Inaba Y, Morita S, Sugano N, Tanaka S, Matsuda S, Akiyama H. Recombinant human FGF-2 for the treatment of early-stage osteonecrosis of the femoral head: TRION, a single-arm, multicenter, Phase II trial. Regen Med 2021; 16:535-548. [PMID: 34075804 DOI: 10.2217/rme-2021-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: This study aimed to evaluate the 2-year outcomes from a clinical trial of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Patients & methods: Sixty-four patients with nontraumatic, precollapse and large ONFHs were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Setting the end point of radiological collapse, we analyzed the joint preservation period of the historical control. Changes in two validated clinical scores, bone regeneration and safety were evaluated. Results: Radiological joint preservation time was significantly higher in the rhFGF-2 group than in the control group. The ONFHs tended to improve to smaller ONFHs. The postoperative clinical scores significantly improved. Thirteen serious adverse events showed recovery. Conclusion: rhFGF-2 treatment increases joint preservation time with clinical efficacy, radiological bone regeneration and safety.
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Affiliation(s)
- Yutaka Kuroda
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takeyuki Tanaka
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Takaki Miyagawa
- Department of Orthopedic Surgery, Gifu University, Gifu, 501-1194, Japan
| | - Hidetoshi Hamada
- Department of Orthopedic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Hiroyasu Abe
- Department of Biomedical Statistics & Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan
| | - Toshiko Ito-Ihara
- The Clinical & Translational Research Center, Kyoto Prefectural University of Medicine, Kyoto, 602-0841, Japan
| | - Ryuta Asada
- Innovative & Clinical Research Promotion Center, Graduate School of Medicine, Gifu University, Gifu, 501-1194, Japan
| | - Yusuke Fujimoto
- Department of Medical Joint Materials, Graduate School of Medical & Dental Sciences, Kagoshima University, Kagoshima, 890-8520, Japan
| | - Daisuke Takahashi
- Department of Orthopedic Surgery, Faculty of Medicine & Graduate School of Medicine, Hokkaido University, Hokkaido, 060-8648, Japan
| | - Tomonori Tetsunaga
- Department of Orthopedic Surgery, Okayama University, Okayama, 700-0914, Japan
| | - Ayumi Kaneuji
- Department of Orthopedic Surgery, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Michiaki Takagi
- Department of Orthopedic Surgery, Yamagata University Faculty of Medicine, Yamagata, 990-2331, Japan
| | - Yutaka Inaba
- Department of Orthopedic Surgery, Yokohama City University, Kanagawa, 236-0004, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics & Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan
| | - Nobuhiko Sugano
- Department of Orthopedic Medical Engineering, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Shuichi Matsuda
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Haruhiko Akiyama
- Department of Orthopedic Surgery, Gifu University, Gifu, 501-1194, Japan
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