scholarly journals ROLE OF MANJISTHADI KSHARA BASTI IN MANAGEMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD – CASE REPORT

2021 ◽  
Vol p5 (02) ◽  
pp. 2763-2767
Author(s):  
Chandu Metri ◽  
Premalata Kamate ◽  
Namrata Bhagaje
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Pain Treatment ◽  
Total Joint Replacement ◽  
Financial Burden ◽  
Joint Destruction ◽  
Treatment Modalities ◽  
Range Of Movement ◽  
Joint Replacement Surgery

Avascular necrosis (AVN) of femoral head is the most common type of necrosis affecting the bones. Avascular necrosis of the bone is the death of osteocytes due to impaired blood supply. It usually affects people between 30-50 years of age. It is associated with long term use of steroids, medications and exces-sive use of alcohol. It will be asymptomatic in early stages, as the condition progresses there will be gradual increase in pain and restricted range of movement of hip joint in end stage total joint destruction resulting in only surgical treatment. AVN treatment management aims at preserving the structural-functional integrity of bone and relief from the pain. Treatment modalities include administration of pain killers, anti-inflammatory medications (NSAIDS), core decompression (bone graft), modified Whitman or Colonna re-construction, insertion of prosthesis and total joint replacement surgery are carried out as a treatment but causes financial burden and poor prognosis. Here we present a case of 19 years old male diagnosed with AVN of left hip joint. Clinical features in this case of AVN was merely correlated with Ashtivahasroto-dushti (Bone channel-musculoskeletal system) and Majjagatavata and treated with different treatment mo-dalities explained in the context of Majjagatavata and Gambeeravatarakta such as Virechana and Bas-tiChikitsa and treatment outcome was found to be encouraging in the terms of pain relief, relief from ten-derness stiffness, flexible hip movement (improved gait) and no reoccurrence after 2 years in MRI.

scholarly journals Microvascular Density of Rapidly Destructive Arthropathy of the Hip Joint

2005 ◽  
Vol 13 (1) ◽  
pp. 40-45 ◽  
Author(s):  
T Yamakawa ◽  
A Sudo ◽  
M Tanaka ◽  
A Uchida
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Joint Destruction ◽  
Bone Destruction ◽  
Microvascular Density ◽  
Blood Capillaries ◽  
Secondary Osteoarthritis ◽  
Femoral Heads ◽  
Formalin Fixed Paraffin Embedded ◽  
Destructive Arthropathy

Purpose. To assess the vascularity of the femoral head and determine how it is related to the destruction of the arthritic hip joint. The process of destructive arthropathy in arthritic hip joints is variable. Some patients with osteoarthritis of the hip have rapidly progressive destructive changes resulting in the disappearance of the femoral head. Method. Six femoral heads from patients diagnosed with rapidly destructive arthropathy and 6 femoral heads from patients with secondary osteoarthritis caused by acetabular dysplasia were analysed to reveal the association between blood capillaries and osteoclasts. The von Willebrand Factor immunostaining and counterstaining with Mayer's haematoxylin were used to label the microvessels and osteoclasts in formalin-fixed, paraffin-embedded specimens of femoral heads. The numbers of immunostained microvessels and osteoclasts in selected regions were counted. Result. The microvascular density of the bone surfaces of rapidly progressive arthritic hips was hypervascular. Osteoclasts were also found in increased numbers on the bone surfaces of rapidly progressive arthritic hips. The higher microvascular density coincided with extensive bone destruction and with the increased osteoclast count. Conclusion. These findings suggested that hypervascularity of the granulation in the femoral head may be associated with bone and joint destruction.

Results of applying minimally invasive two-stage decompression with bone alloplasty for avascular necrosis of the femoral head

2021 ◽  
Vol 19 (3) ◽  
pp. 69-74
Author(s):  
A. V. ANTONOV ◽  
◽  
V. E. VOLOVIK ◽  
A. G. RYKOV ◽  
S. N. BEREZUTSKIY ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Minimally Invasive ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Rapid Development ◽  
Young Patients ◽  
Walking Distance ◽  
Joint Function ◽  
Two Stage

Avascular necrosis of the femoral head is a complex medical and social problem. The rapid development of the disease, the complexity of diagnosis and the prevalence among young patients leads to impaired hip joint function and further disability. To improve the quality of life of patients, the Orthopedic Department of the Traumatology Center of Khabarovsk developed a method of minimally invasive two-stage decompression. Surgical treatment was performed in 30 cases in patients with ANFH of stages 0, 1, 2 (by ARCO). Evaluation of treatment results was carried out before operative treatment, after 6 and 12 months. 12 months after surgical treatment, positive dynamics was noted, namely, pain reduction, a walking distance increase, abandonment of crutches, opportunity to use public transport, ability to sit for a long time in one and the same position, to put on shoes, and the abandonment of constant intake of non-steroidal anti-inflammatory drugs. The assessment of hip joint function in 20% of cases showed an excellent result, in 26,6% of cases — a good result, in 40% — satisfactory, and in 13,3% (4 people) — unsatisfactory result, which proves the effectiveness of the proposed treatment method and the feasibility of its use.

scholarly journals A novel mutation of COL2A1 in a large Chinese family with avascular necrosis of the femoral head

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Zeng Zhang ◽  
Kechao Zhu ◽  
Huiyong Dai ◽  
Qi Wang ◽  
Changqing Zhang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Clinical Diagnosis ◽  
Hip Joint ◽  
Bone Disease ◽  
Novel Mutation ◽  
Chinese Family ◽  
Heterozygous Mutation ◽  
Joint Function ◽  
Subsequent Loss

AbstractAvascular necrosis of the femoral head (ANFH) is a debilitating bone disease, characterized by collapse of the femoral head and subsequent loss of hip joint function. Heterozygous mutations in COL2A1 have been identified to cause familial ANFH. Here we report on a large Chinese family with ANFH and a novel heterozygous mutation (c.3517 G > A, p.Gly1173Ser) in exon 50 of COL2A1 in the Gly-X–Y domain. Previously, only five different COL2A1 mutations have been described in patients with familial ANFH. Therefore, our findings provide significant clues to the phenotype–genotype relationships in familial ANFH and may be helpful in clinical diagnosis. Furthermore, these results should assist further studies of the mechanisms underlying collagen diseases.

scholarly journals Avascular Necrosis of the Femoral Head: A Case Report with Emphasis on Imaging Findings

2013 ◽  
Vol 2 (2) ◽  
pp. 92-95
Author(s):  
S Ansari ◽  
K Dhungel ◽  
K Ahmad ◽  
MK Gupta ◽  
MF Amanullah ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Replacement ◽  
Joint Destruction ◽  
Accurate Method ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Avascular necrosis (AVN) of the femoral head is a disease caused by reduced blood supply to the subchondral bone leading to destruction of the hip joint. Most common sites are femoral and humeral head. Initially, patients are asymptomatic, but, in time, AVN leads to joint destruction, requiring surgical treatment and, in later stages, total hip replacement. Magnetic resonance imaging (MRI) has been proved to be a highly accurate method both for early diagnosis and for staging of the disease. We present a case of avascular necrosis of right femoral head in 28 year old male following trauma to hip. Nepalese Journal of Radiology; Vol. 2; Issue 2; July-Dec. 2012; 92-95 DOI: http://dx.doi.org/10.3126/njr.v2i2.7694

scholarly journals The first experience of arthroscopy in the case of aseptic necrosis of the femoral head

2021 ◽  
pp. 39-44
Author(s):  
Maxim Golovakha ◽  
Vadym Kirichenko ◽  
Olexandra Grytsenko ◽  
Rostyslav Tytarchuk ◽  
Stanislav Bondarenko
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Comparison Group ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Hip Joint Replacement ◽  
Therapeutic Exercises

Observation of patients with avascular necrosis of the femoral head formed a hypothesis about inability to eliminate the hip contracture by tunneling the femoral head on the background of drug therapy and therapeutic exercises, which causes an unsatisfactory outcomes. Therefore, the was idea to use arthroscopy for performing capsulotomy, synovectomy and removal of free cartilage and bone fragments. Objective. To evaluate efficiency of arthroscopy in patients with avascular necrosis of the femoral head. Methods. In the period from 2010 to 2018, 60 patients were observed. With the I–II stages, absence of inflammatory processes in the joint, body mass index less than 35. In the comparison group (28 patients) we made  only tunneling of the femoral head, in the study group (32) at first  we performed arthroscopy of the hip joint, capsulotomy, synovectomy, removal of cartilage fragments, and only then — tunneling. We analyzed the proportion of hip joint replacement that was performed in the long term follow up and the intensity of pain by visual analog scale. Results. During arthroscopy we often revealed the joint cartilage lesions — 30 %, articular labrum lesions — 5 %, synovitis — 100 %, CAM impingement — 90 %. In the study group in the first 2 weeks after surgery, the pain was severe more than in the comparison group. Then the pain rate became the same in both groups. In the control group in the period from 3 to 5 years after tunneling of the femoral head, arthroplasty was performed in 11 patients (39.3 %), in the study group for 2 to 3 years after surgery — 8 (25.0 %). Conclusions. Analysis of long-term results of tunneling of the femoral head with arthroscopy of the hip joint in patients with avascular necrosis of the femoral head showed improvement in hip function, no disease progression in 60–75 % patients in 2–3 years after surgery.

scholarly journals Extensive Recontouring of the Femoral Head with Osteochondral Allografting: A Case Report with Histological and MicroCT Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Amir A. Jamali ◽  
Douglas Rowland ◽  
Kristen N. Vandewalker
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Posttraumatic Growth ◽  
Avascular Necrosis ◽  
Hip Joint ◽  
Case Reports ◽  
Young Patients ◽  
Osteochondral Allograft ◽  
Microct Analysis ◽  
Osteochondral Allografts

Morphological abnormalities such as cam deformity or growth disturbances can have a detrimental effect on the smooth function of the hip joint. This case reports an attempt to salvage the hip joint of a young patient with a posttraumatic growth disturbance of the femoral head using a fresh osteochondral allograft. This treatment has been used very rarely in the femoral head due to the presumed tenuous blood supply of the head and the perceived risk of nonunion or progressive avascular necrosis. The patient in this case had persistent pain and mechanical symptoms leading to hip replacement. A detailed analysis of the retrieved femoral head demonstrated durability and healing of the grafts based on gross inspection, histology of bone and cartilage, and microCT analysis. This case is the first report to our knowledge of a detailed histological and radiographic analysis of the fate of osteochondral allografts of the femoral head. We hope that this case provides justification for the use of osteochondral allografts of the femoral head for other indications such as femoral head fractures, avascular necrosis, and benign epiphyseal tumors of the femoral head in an effort to avoid arthroplasty in young patients. The authors have obtained the patient’s informed written consent for print and electronic publication of the case report.

scholarly journals A Novel Mutation of COL2A1 in a Large Chinese Family with Avascular Necrosis of the Femoral Head

2021 ◽  
Author(s):  
Zeng Zhang ◽  
Kechao Zhu ◽  
Huiyong Dai ◽  
Qi Wang ◽  
Changqing Zhang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Clinical Diagnosis ◽  
Hip Joint ◽  
Bone Disease ◽  
Novel Mutation ◽  
Chinese Family ◽  
Heterozygous Mutation ◽  
Joint Function ◽  
Subsequent Loss

Abstract Avascular necrosis of the femoral head (ANFH) is a debilitating bone disease, characterized by collapse of the femoral head and subsequent loss of hip joint function. Heterozygous mutations in COL2A1 have been identified to cause familiar ANFH. Here we report on a large Chinese family with ANFH and a novel heterozygous mutation (c.3517 G > A, Gly1173Ser) in exon 50 of COL2A1 in the Gly-X-Y domain. Previously, only five different COL2A1 mutations have been described in patients familiar ANFH. Therefore, our findings provide significant clues to the phenotype-genotype relationships in familiar ANFH and may be helpful in clinical diagnosis. Furthermore, these results should assist further studies of the mechanisms underlying collagen diseases.

Role of plain radiograph versus MRI in avascular necrosis of femoral head

2021 ◽  
Vol 12 (2) ◽  
pp. 69-71
Author(s):  
Amit H Deshmukh ◽  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Joint Destruction ◽  
Plain Radiograph ◽  
Health Care Centre ◽  
X Ray ◽  
One Year ◽  
The One ◽  
Necrosis Of Femoral Head

Background: Avascular necrosis of the femoral head (AVN) is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Although patients are initially asymptomatic, AVN usually progresses to joint destruction, usually before the fifth decade. Aims and Objectives: To study role of plain radiograph versus MRI in Avascular Necrosis of Femoral head. Methodology: This was a cross-sectional study carried out in the patients clinically suspected of avascular necrosis of femur at tertiary health care centre during the one year period i.e. January 2018 to January 2019 during the one year period there were 37 patients suspected of avascular necrosis of Femur The sensitivity and specificity was calculated by ROC curves from the medcal software.Result: In our study we have seen that the sensitivity (Sn)and Specificity (Sp) for X-ray and MRI respectively for various stages was For STAGE Iwas34.29, 29.12and98.45,95.12 ;forSTAGE IIwas 75.12,68.23 and 99.17,98.27;forSTAGE III98.56,93.12and99.69,98.36;forSTAGE IV99.34,92.19and100,99.19 . Conclusion: It can be concluded from our study that in the early stages of disease MRI was highly sensitive and specific as compared to plain X-ray hence MRI should be preferred over the plain X-ray in the confirmation and early surgical intervention if any.

scholarly journals EFFECT OF MAJJA BASTI AND BAHYA SNEHANA (PIZICHIL) IN AVASCULAR NECROSIS - A CASE REPORT

2021 ◽  
Vol 9 (10) ◽  
pp. 2572-2577
Author(s):  
Bunker Surendra ◽  
Dixit Neetu ◽  
Dash Babita
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Medical Science ◽  
Bone Destruction ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Long Bone ◽  
Loss Of Function ◽  
Permanent Loss ◽  
Male Patients

Avascular necrosis (AVN) also called osteonecrosis or a disorder resulting from a temporary or permanent loss of blood supply or interruption of supply to the bone. AVN is found in the age of 30- 40 years mostly. Blood carries essential nutrients and oxygen to the bone. When the supply is disrupted, the bone tissue became necrosed. AVN can occur at any bone but most commonly affects the ends (epiphysis) of a long bone such as thigh region bone i.e. femur characterized by the collapse of bone, pain, bone destruction, limping off the leg, loss of function of affected bone (temporary or permanent). Modern medical science has surgical treatment modalities like Arthroplasty, hip replacement and osteotomy etc having a higher failure rate is also cost worthy and has a poor prognosis. As per Ayurveda, the cases were diagnosed as Asthimajjagata vata vikara. In the present study, two male patients one is 45 years old another is 30 years old having signs and symptoms of Avascular necrosis and X- ray of bilateral hip joint showing AVN of the femoral head were taken into consideration and administered the therapy, Majja Basti, bahya snehana (pizichil) and the Shaman Kashaya i.e. Guggulu Tiktak Kashaya 20 ml BD for 15 days.significant relief with increasing functional femoral activities in the necrosed femoral head. Based on these case study it can be concluded that the Panchakarma treatment along with Shamana chikitsa is effective in the management of AVN of the femoral head. Keywords: Avascular necrosis, Asthimajja gata vata vikar, Majja Basti, Pizichil.

SERIAL IMAGING OF A CHILD WITH LEGG-CALVE-PERTHES DISEASE AT BETHESDA HOSPITAL, YOGYAKARTA: A CASE REPORT

2020 ◽  
Vol 5 (2) ◽  
pp. 48
Author(s):  
Jourdy Kharisma Pradnyana
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Pain Treatment ◽  
Rare Condition ◽  
Perthes Disease ◽  
Imaging Studies ◽  
Modest Improvement ◽  
Limited Mobility ◽  
Initial Imaging ◽  
Skin Traction

Background: Legg-Calve-Perthes disease (LCPD) is a rare condition of idiopathic avascular necrosis of the femoral head, mostly affects children under fifteen old. Most cases only affect one femoral head; bilateral involvement only occurs in about 15% of cases. Early diagnosis and prompt intervention play an important role in the prognosis to prevent degenerative damage on the bones and joints. Objective: To describe a case of Legg-Calve-Perthes disease in a 9-year-old boy in Bethesda Hospital, Yogyakarta. Case Description: A 9-year-old boy came with one month history of worsening pelvic pain to Bethesda Hospital, Yogyakarta. He also showed limping and limited mobility. Initial imaging studies did not find any abnormalities. Further follow-up with MSCT scan related to the complaint of persistent pain showed defects of left hip joint indicating Legg-Calve-Perthes disease. The patient undergone skin traction treatment which shows modest improvement on serial radiographic examinations during hospital admission. Conclusion: The rarity of LCPD warrant thorough imaging studies on children with unexplainable severe hip joint pain. Treatment should be initiated as early as possible after diagnosis to prevent further bone damage and worsening prognosis. Conservative management with skin traction would benefit the patient in restoring normal anatomy and optimal joint congruence to prevent degenerative damage to the joints.

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