Transcriptomic integration and ligand-receptor crosstalk reveal the underlying molecular mechanisms between hip cartilage and subchondral bone in osteonecrosis of femoral head.

Osteonecrosis of femoral head (ONFH) is characterized not only by ischemic bone tissue necrosis but also by cartilage degeneration, which plays an essential role in the pathogenesis of ONFH. The molecular communication between tissues contributes to disease progression, however the communication between cartilage and subchondral bone in the progression of ONFH remains unclear. In this study, we integrated transcriptomic data from ONFH cartilage and subchondral bone, exploring common differentially expressed genes (DEGs), pathway and function enrichment analyses, the protein-protein interaction (PPI) network, and hub genes to comprehensively study molecular integration.

Techniques of core decompression in the treatment of idiopathic avascular necrosis of the femoral head.

Core decompression was developed as a joint-preserving procedure for patients with early-stage osteonecrosis of the femoral head. Previous studies indicated a high success rate that outperforms nonoperative management of pre-collapse hips. The traditional single-tunnel core decompression technique uses a cannulated drill bit inserted into the lateral cortex of the proximal femur.

Subtrochanteric shortening osteotomy in adult sickle cell disease patients with cemented total hip arthroplasty for hip deformities secondary to childhood osteonecrosis: is healing a challenge?

Purpose: Hip deformity is frequent after childhood osteonecrosis in patients with sickle cell disease (SCD). When they are adults, they present a challenge as candidates for total hip arthroplasty (THA) because of abnormal bone development, their relative youth, and also because of their disease. Performing subtrochanteric osteotomy associated with THA is technically challenging, and healing of osteotomies has never been reported in this population with frequent osteonecrotic bone, whether using cemented or uncemented arthroplasties.

Asymptomatic multifocal avascular necrosis, a commonly overlooked finding in patients with systemic lupus erythematosus.

Background: In patients with Systemic lupus erythematosus (SLE), osteonecrosis of various joints is a debilitating complication associated with the disease and its treatment, in which a considerable proportion of osteonecrosis may be asymptomatic. Recognizing the crucial role of early and timely detection, as well as appropriate management of asymptomatic osteonecrosis, in preventing joint destruction, we conducted a study to evaluate the prevalence of asymptomatic osteonecrosis in SLE patients who have already been diagnosed with symptomatic osteonecrosis. Additionally, we aimed to examine the relationship between proposed risk factors of osteonecrosis and the development of asymptomatic osteonecrosis.

Fully-threaded cannulated screws versus partially-threaded cannulated screws for femoral neck fractures: a systematic review and meta-analysis.

Objective: Femoral neck fractures (FNFs) are a common orthopedic type, and there are many treatment methods for it, and cannulated screw internal fixation is currently one of the main treatment methods. The choice of fully threaded cannulated screw (FCS) or partially threaded cannulated screw (PCS) remains controversial. Therefore, we performed this meta-analysis to evaluate the outcomes of FCS and PCS in the treatment of FNF.

Postoperative complications and cost implications in sickle cell disease patients undergoing total hip arthroplasty: A national inpatient sample study.

Background: Sickle cell disease (SCD) is a genetic condition affecting approximately 5 % of the global population, with significant prevalence in sub-Saharan Africa and an estimated 89,079 cases in the United States. Osteonecrosis, particularly of the femoral head (ONFH), is a common orthopaedic complication in SCD, often requiring total hip arthroplasty (THA) when conservative treatments fail. While THA can improve pain and function, it carries significant perioperative risks, with complication rates in patients with SCD as high as 67 %.

Incidence and risk factors for unplanned readmission after total hip arthroplasty for osteonecrosis of the femoral head.

Objective: To investigate the incidence, primary causes, and risk factors for unplanned readmissions within one year after the first primary total hip arthroplasty (THA) for osteonecrosis of the femoral head (ONFH).

Methods: Data were retrospectively collected from patients who had undergone the first primary THA for ONFH at two tertiary hospitals between January 2021 and December 2022, with complete 1-year follow-up assessments. Patients who experienced an unplanned readmission within 1 year were classified as the readmission group, while the others as the non-readmission group.

Long-term results of short stem total hip arthroplasty in patients with osteonecrosis of the femoral head.

Introduction: Short stem total hip arthroplasty (THA) is an alternative to conventional stem, designed to facilitate minimal-invasive surgery, physiological loading and preserve bone stock. However, there is insufficient evidence of the long-term outcomes in patients with osteonecrosis of the femoral head (ONFH). This study aims to analyze the clinical and radiographic results with a minimum follow-up of 10 years.

Do children <3years at index surgery for DDH have a better outcome at mid-term follow-up in comparison to children >3years at index surgery? A prospective comparative study.

Background: Diagnosis and management of developmental dysplasia of hip (DDH) in underdeveloped regions is frequently delayed, potentially impacting final outcomes. This prospective study was conducted with the aim of answering the question, "Do children <3 years at index surgery for DDH have better outcome at 5-year follow-up in comparison to children >3 years at index surgery?"

Methods: Between 2016 and 2021, all walking-age children with DDH were prospectively enrolled in the study. The study cohort was divided into 2groups: Group 1 ⩽3 years of age, and Group 2 included children >3 years old.

Endoscopic obturator nerve radiofrequency ablation for femoral head necrosis: a case series.

Background: This pilot case series evaluated the feasibility and effectiveness of using endoscopic radiofrequency ablation (RFA) of the articular branch of the anterior obturator nerve under endoscopic and fluoroscopic guidance for controlling pain in patients with osteonecrosis of the femoral head (ONFH).

Methods: Data on 11 consecutive patients were collected with ONFH underwent endoscopic RFA of the anterior obturator nerve. Electromyography (EMG) examination was performed preoperatively and postoperatively.

Incidence of Avascular Necrosis of the Femoral Head Post Hip Reduction Surgery in Children With Cerebral Palsy.

Avascular necrosis (AVN) of the femoral head confers a risk of morbidity amongst cerebral palsy (CP) patients. Meanwhile, the proportion who develop AVN post hip reduction surgery is unclear, and the risk factors are not established. To estimate the incidence and risk factors for AVN post hip reduction surgery in CP patients, we reviewed and analysed literature from Medline, Embase, and Web of Science repositories between January 1, 1990, and August 31, 2024.

Short-term outcomes of AVN CAGE implantation for early-stage osteonecrosis of the femoral head.

Purpose: Considering the low survival rate for the numerous hip-preserving procedures developed for treating early-stage osteonecrosis of the femoral head (ONFH), this study aimed to evaluate short-term clinical outcomes following avascular necrosis (AVN) CAGE implantation.

Methods: 58 hips with early-stage ONFH (44 with Association Research Circulation Osseous [ARCO] stage 2 and 14 with stage 3A) treated with the AVN CAGE between August 2018 and December 2021 were included. The survival rates were analysed using radiographic progression and conversion to subsequent total hip arthroplasty (THA) as endpoints.

Predictive value of preoperative gluteus and iliacus muscle volumes for patient-reported outcomes following total hip replacement: a three-dimensional volumetric analysis.

Introduction: This study aimed to investigate the relationship between hip muscle mass and patient-reported outcomes (PROs) after total hip arthroplasty (THA) surgery for hip disease using 3D volumetric measurements of the gluteus muscle group and iliac muscle.

Materials And Methods: Between January 2020 and December 2021, 85 patients who had undergone unilateral THA for osteoarthritis or osteonecrosis of the femoral head were enrolled. Using a 3D modeler program, automatically generated 3D reconstructed images of the hip muscles were obtained, and volumetric measurements were performed.

Bilateral Total Hip and Right Knee Arthroplasty in a Sickle Cell Disease Patient with Multiple Joint Osteonecrosis: A Case Report and Literature Review.

Sickle cell disease is an autosomal recessive genetic disorder with the underlying pathology, resulting in sickling of the red blood cells in deoxygenated conditions. Osteonecrosis is a common orthopaedic manifestation of sickle cell disease, and total joint arthroplasty is the preferred option in managing patients with advanced disease. This article describes bilateral total hip arthroplasty and right total knee arthroplasty (TKA) in a 41-year-old woman, a known haemoglobin SS (HBSS) patient who presented to the outpatient clinic of National Orthopaedic Hospital, Igbobi, Lagos, with recurrent bilateral hip and right knee pain of 10-year duration, with associated stiffness, valgus deformity in the knee and severe limitation of function.

Histopathologic confirmation of subchondral fracture in symptomatic pre-collapse osteonecrosis of the femoral head with bone marrow edema on magnetic resonance imaging.

Objective: The presence of bone marrow edema on magnetic resonance imaging (MRI) in pre-collapse osteonecrosis of the femoral head is suggested to be a sign of occult subchondral fracture; however, to our knowledge, there are no histopathological studies verifying this. This study aimed to histopathologically verify the presence of subchondral fracture at the lateral necrotic boundary in symptomatic pre-collapse osteonecrosis of the femoral head with bone marrow edema on MRI.

Materials And Methods: Of 149 consecutive necrotic femoral heads resected during total hip arthroplasty at our hospital from January 2019 to June 2024, we included 13 femoral heads that did not show apparent collapse on preoperative radiographs and exhibited bone marrow edema on MRI.

Radiological Assessment of Fusobacterium Necrophorum Osteomyelitis and Septic Arthritis: A Case Report.

This case report presents a unique case of pediatric Fusobacterium necrophorum osteomyelitis and septic arthritis, emphasizing the role of radiological imaging in diagnosis, treatment planning, and monitoring. Fusobacterium necrophorum, typically a member of the head and neck flora, is an uncommon causative agent of osteomyelitis, making this case particularly noteworthy. A 17-year-old male, with a history of recurrent otalgia, presented with worsening right otalgia, otorrhea for six days, headache, decreased range of motion of the neck to the right, and right hip pain.

Legg-Calve´-Perthes disease - diagnostic value of acetabular-femoral head match index.

Early treatment of Legg-Calve´-Perthes disease (LCPD)can improve hip joint activity and life management in adulthood. However, the current classification of LCPD is based on imaging findings in the fragmented stage of the disease, which is prone to delay treatment. Therefore the aim of this study is to evaluate the potential risk factors associated with poor radiological outcomes of LCPD, and to develop a new index for hip consistency evaluation, which can be used to speculate radiographic outcomes at the time of the first visit.

Internal Fixation With Cannulated Screws for Stable Femoral Neck Fractures in High-Risk Patients: Good Clinical Outcomes and Evaluation of Postoperative Complications.

This study aimed to investigate the clinical outcome and the postoperative complications after internal fixation with cannulated screws of stable femoral neck fractures (FNFs) in high-risk patients. A total of 76 patients (mean age 70.11 ± 9.

Mechanism of action of Salvia miltiorrhiza on avascular necrosis of the femoral head determined by integrated network pharmacology and molecular dynamics simulation.

Avascular necrosis of the femoral head (ANFH) is a progressive, multifactorial, and challenging clinical condition that often leads to hip dysfunction and deterioration. The pathogenesis of ANFH is complex, and there is no foolproof treatment strategy. Although some pharmacologic and surgical treatments have been shown to improve ANFH, the associated side effects and poor prognosis are of concern.