Objective: Femoral head necrosis (FHN) affects mostly young and active people. The most common operative therapy is core decompression (CD) with optional cancellous bone grafting (CBG). Because little information is available on the long-term results of these procedures, we investigated the effectiveness of CD and CD + CBG in patients with ARCO stage II FHN in terms of postoperative pain, range of motion, patient-reported outcome measures (Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score, EuroQol 5D, and Short Form 36 Questionnaire), and disease progression.
Methods: We retrospectively compared 11 patients treated with CD alone 48.0 months (range, 26.3-68.5 months) postoperatively versus 11 patients treated with CD + CBG 69.2 months (range, 38.0-92.9 months) postoperatively. All patients were assessed according to a routine clinical protocol involving a clinical examination, questionnaires, and radiological imaging (X-ray and magnetic resonance imaging).
Results: The clinical and radiological results showed no significant differences between the two groups. Both interventions demonstrated equal results according to clinical scores.
Conclusions: Our data may encourage application of the less invasive technique of CD alone without CBG, which is more surgically demanding. Further prospective studies with longer follow-up are necessary to clarify the risk factors for therapy failure.
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http://dx.doi.org/10.1177/03000605231190453 | DOI Listing |
BMC Med Inform Decis Mak
January 2025
Department of Orthopedics, the First Hospital of Jilin University, Changchun, Jilin Province, 130021, China.
Purpose: Identifying patients who may benefit from multiple drilling are crucial. Hence, the purpose of the study is to utilize radiomics and deep learning for predicting no-collapse survival in patients with femoral head osteonecrosis.
Methods: Patients who underwent multiple drilling were enrolled.
Arthrosc Tech
December 2024
Department of Orthopaedic Surgery, University of California Irvine, Orange, California, U.S.A.
Although specific techniques vary, core decompression is generally accepted as the treatment of choice for precollapse avascular necrosis (AVN) of the hip to delay or prevent progression of the disease. This can be combined with hip arthroscopy to allow visual assessment of the femoral head as well as treatment of intra-articular pathologies, which may contribute to pain and joint degeneration. We describe a technique of hip arthroscopy and concurrent core decompression using an expandable reamer and bone grafting for treatment of hip AVN.
View Article and Find Full Text PDFBiomedicines
December 2024
Department of Orthopedics Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Background: Glucocorticoids (GCs) are critical regulatory molecules in the body, commonly utilized in clinical practice for their potent anti-inflammatory and immunosuppressive properties. However, prolonged, high-dose GC therapy is frequently associated with femoral head necrosis, a condition known as glucocorticoid-induced osteonecrosis of the femoral head (GC-ONFH). Emerging evidence suggests that enhanced autophagy may mitigate apoptosis, thereby protecting osteoblasts from GC-induced damage and delaying the progression of ONFH.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
Background: Osteonecrosis of the femoral head (ONFH) is a challenging condition, primarily affecting young and middle-aged individuals, which results in hip dysfunction and, ultimately, femoral head collapse. However, the comparative effectiveness of joint-preserving procedures, particularly in the early stages of ONFH (ARCO stage I or II), remains inconclusive. This study aims to evaluate the efficacy of a novel technique called small-diameter core decompression (CD) combined with platelet-rich plasma (PRP), for the treatment of early-stage ONFH.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan; University of Tokyo Spine Group (UTSG), 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Background: Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement.
Methods: A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022.
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