scholarly journals Avascular Necrosis of Bone following Chemotherapy in Cancer Patients with Coagulopathy: Report of Two Cases

2018 ◽  
Vol 11 (1) ◽  
pp. 185-190 ◽  
Author(s):  
Hui-Ching Hsu ◽  
Tzu-Yao Liao ◽  
Dave Wei-Chih Chen ◽  
Yu-Hsiang Juan ◽  
Chuang-Chi Liaw
Keyword(s):  
Cancer Patients ◽  
Solid Tumors ◽  
Avascular Necrosis ◽  
Hip Arthroplasty ◽  
Groin Pain ◽  
Paraneoplastic Syndromes ◽  
The Other ◽  
Thromboembolic Complications ◽  
Femoral Heads ◽  
Avascular Necrosis Of Bone

We report 2 cases of patients with solid tumors and coagulopathy who experienced avascular necrosis (AVN) of the bone following chemotherapy. Both cases exhibited nontraumatic bilateral AVN of the femoral heads, and one also showed bilateral AVN of the humeral heads. One case had multiple thromboembolic complications, including pulmonary obstructive syndrome and paraneoplastic pain. The other showed multiple paraneoplastic syndromes, with hypercalcemia and thrombocytosis. Groin pain and claudication of the lower extremities developed and persisted. Both patients eventually received bilateral hip arthroplasty due to AVN of both femoral heads.

scholarly journals Avascular necrosis of bone in childhood cancer patients: a possible role of genetic susceptibility

2015 ◽  
Vol 116 (05) ◽  
pp. 289-295
Author(s):  
L. Geczova ◽  
A. Soltysova ◽  
J. Gecz ◽  
S. Sufliarska ◽  
J. Horakova ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Genetic Susceptibility ◽  
Cancer Patients ◽  
Avascular Necrosis ◽  
Avascular Necrosis Of Bone

Bipolar versus Total Hip Arthroplasty in the Treatment of Avascular Necrosis of the Femoral Head in Young Patients

2002 ◽  
Vol 12 (2) ◽  
pp. 142-149 ◽  
Author(s):  
T. Scheerlinck ◽  
M. Dezillie ◽  
A. Monsaert ◽  
P. Opdecam
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Avascular Necrosis ◽  
Hip Arthroplasty ◽  
Groin Pain ◽  
Functional Result ◽  
Young Patients ◽  
Total Hip ◽  
Lost To Follow Up

The authors evaluate medium-term results of bipolar and total hip arthroplasty as a treatment for avascular necrosis of the femoral head. Between 1990 and 2000, 57 hips (45 patients) were treated with a bipolar (BHA: 37 hips) or total hip arthroplasty (THA: 20 hips) depending on the radiographic and macroscopic aspect of the acetabulum. At surgery, all patients were under 65 years of age (average: 45.09 years). All had the same cementless hydroxylapatite coated femoral stem inserted through an anterolateral approach. The BHA were followed during a mean of 4.49 years. One BHA was lost to follow-up. Seven out of 36 hips (19.44%) were considered failures: three due to a poor functional result (Harris Hip Score (HHS) <70) and four which needed conversion to THA for groin pain. Two hips were revised for periprosthetic fracture. Twenty BHA (55.56%) had a good or excellent result (HHS 80). The THA were followed for a mean of 4.32 years. One THA was lost to follow-up. Four out of 19 hips (21.05%) were considered as failures. Three due to a poor functional result (HHS<70) and one which needed cup revision for recurrent dislocation. Fifteen THA (78.95%) had a good or excellent functional result (HHS80). BHA as a treatment of avascular necrosis of the femoral head in young patients preserves bone stock for later revisions and can lead to excellent results. But the outcome seems less predictable than after THA. Groin pain associated to BHA can be treated successfully with conversion to THA if necessary.

scholarly journals Failed vascularized fibular graft in treatment of osteonecrosis of the femoral head. A histopathological analysis

Joints ◽  
2016 ◽  
Vol 04 (01) ◽  
pp. 024-030 ◽  
Author(s):  
Maria Meloni ◽  
W. Hoedemaeker ◽  
Victor Fornasier
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Avascular Necrosis ◽  
Hip Arthroplasty ◽  
Graft Failure ◽  
Histopathological Analysis ◽  
Fibular Graft ◽  
Vascularized Fibular Graft ◽  
Total Hip ◽  
Femoral Heads

Purpose: vascularized fibular grafting has been used to treat osteonecrosis of the femoral head in younger patients. Although the results described in the literature are promising, the failure rate is still significant, especially in steroid users. This study was undertaken to learn more, on a histopathological level, about the mechanism of vascularized fibular graft failure. Methods: fifteen femoral heads removed at conversion to total hip arthroplasty were analyzed. The case load comprised 10 men and 5 women. They ranged in age from 28 to 39 years and had a median age of 35 years. The interval between the vascularized fibular implant procedure and the conversion to total hip arthroplasty ranged from 22 months to 30 months; the median interval was 26 months. All the patients were steroid users. The heads were sectioned and axial and coronal sections were taken and stained using the WHO method (hematoxylin, phloxine, saffron and Alcian green). A quantitative and qualitative analysis of graft-host interaction at the head (zone 1), neck (zone 2) and epiphysis (zone 3) was performed. Results: all the specimens showed recognizable collapse of the articular surface over the area of necrosis. Thirteen femoral heads showed the presence of an osteochondral flap attached only at the margins of the area of avascular necrosis, and 10 of these 13 femoral heads also showed loss of the articulating surface with an ulcer crater corresponding to the exposed area of avascular necrosis. Conclusions: vascularized fibular graft failure seems to be related to a negative effect of creeping substitution: the revascularization becomes a negative force as it supports unbalanced bone resorption, which, as is well known, is enhanced by corticosteroids. Clinical relevance: creeping substitution is an undermining force in the repair and revascularization of the necrotic area in the femoral head.

Total Hip Arthroplasty for Avascular Necrosis and Degenerative Osteoarthritis of the Hip

1997 ◽  
Vol 341 ◽  
pp. 62???68 ◽  
Author(s):  
Theodore A. Xenakis ◽  
Alexandros E. Beris ◽  
Konstantinos K. Malizos ◽  
Theodosios Koukoubis ◽  
John Gelalis ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Avascular Necrosis ◽  
Hip Arthroplasty ◽  
Osteoarthritis Of The Hip ◽  
Degenerative Osteoarthritis ◽  
Total Hip

Avascular Necrosis of Bone following Revascularization of the Thumb

1979 ◽  
Vol 3 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Charles F.T. Snelling ◽  
Philip M. Hendel
Keyword(s):  
Avascular Necrosis ◽  
Avascular Necrosis Of Bone

Avascular necrosis of bone in bone marrow transplant patients

1989 ◽  
Vol 17 (2) ◽  
pp. 140-143 ◽  
Author(s):  
J. A. Russell ◽  
W. B. Blahey ◽  
T. A. Stuart ◽  
G. Edwards ◽  
R. T. Card
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Avascular Necrosis ◽  
Marrow Transplant ◽  
Transplant Patients ◽  
Avascular Necrosis Of Bone
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