scholarly journals Hitting the Mark: Optimizing the Use of Calcium Phosphate Injections for the Treatment of Bone Marrow Lesions of the Proximal Tibia and Distal Femur

2018 ◽  
Vol 7 (10) ◽  
pp. e1013-e1018 ◽  
Author(s):  
Brian J. Rebolledo ◽  
Kevin M. Smith ◽  
Jason L. Dragoo
Keyword(s):  
Bone Marrow ◽  
Calcium Phosphate ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Bone Marrow Lesions

Talar Avascular Necrosis After Calcium Phosphate Injection Treatment of Talar Bone Marrow Lesions

2020 ◽  
Vol 10 (2) ◽  
pp. e19.00389-e19.00389
Author(s):  
Jessica M. Kohring ◽  
Irvin Oh ◽  
Judith F. Baumhauer
Keyword(s):  
Bone Marrow ◽  
Calcium Phosphate ◽  
Avascular Necrosis ◽  
Bone Marrow Lesions ◽  
Injection Treatment ◽  
Phosphate Injection

scholarly journals Calcium phosphate injection of symptomatic bone marrow lesions of the knee: what is the current clinical evidence?

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
D. S. Angadi ◽  
D. Edwards ◽  
J. T. K. Melton
Keyword(s):  
Bone Marrow ◽  
Calcium Phosphate ◽  
Clinical Outcomes ◽  
Clinical Decision Making ◽  
Short Form ◽  
Case Reports ◽  
Objective Assessment ◽  
Weight Bearing ◽  
Bone Marrow Lesions ◽  
Phosphate Injection

Abstract Background Chronic bone marrow lesions (BML) in the weight-bearing portions of the knee are often associated with symptomatic degenerative arthritis resulting in pain and dysfunction. Injection of bone substitute material like calcium phosphate has been described. Whilst some studies have reported encouraging results others have shown limited benefit of this technique. Aim The aim was to collate the available evidence on the injection of calcium phosphate and systematically evaluate the results to answer the questions encountered in clinical decision making: (1) does it provide effective long-lasting pain relief to avoid further surgical intervention? (2) which factors (patient/surgical) significantly influence the outcome? and (3) does it adversely affect the outcomes of subsequent arthroplasty? Methods A literature search was performed to identify the studies describing the clinical outcomes of calcium phosphate injection for treatment of BML. We evaluated the reported clinical outcomes with respect to pain, function and complications. Isolated case reports and studies with no objective assessment of clinical outcomes were excluded. Results We noted 46 articles in the current literature of which 8 described clinical outcomes of calcium phosphate injection. Mean (plus/minus SD) score on the visual analog scale (VAS) has been reported to improve from 7.90 (± 0.38) to 2.76 (± 0.90), whereas the International Knee Documentation Committee (IKDC) score improved from 30.5 (SD not reported (NR)) to 53.0 (SD NR). Pre and post procedure Short form survey (SF-12) scores were 29.8 (SD NR) and 36.7 (SD NR), respectively. In one study, scores on the Tegner Lysholm knee scoring scale improved in 12 out of 22 patients, whereas the remainder had no change in symptoms. Extravasation of calcium phosphate into the joint was the most common complication, whereas no adverse effect has been reported on subsequent arthroplasty. Conclusion Limited data from the published studies would suggest that calcium phosphate injection of BML may potentially improve pain and function. However, no evidence is currently available to clearly identify patient/surgical factors that may influence the long-term outcomes of this procedure. Hence pragmatic, prospective studies with stratified patient cohorts and robust reporting of outcome measures are essential to improve the understanding of the indications and clinical effectiveness of this novel procedure.

Hisotological and radiographic determination of the age of physeal closure of the distal femur, proximal tibia, and proximal fibula of the New Zealand white rabbit

1994 ◽  
Vol 12 (5) ◽  
pp. 747-749 ◽  
Author(s):  
Moises Kaweblum ◽  
Maria Del Carmen Aguilar ◽  
Eduardo Blancas ◽  
Jaime Kaweblum ◽  
Wallace B. Lehman ◽  
...  
Keyword(s):  
New Zealand ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Zealand White Rabbit ◽  
Proximal Fibula ◽  
New Zealand White Rabbit ◽  
Physeal Closure
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