Efficacy of Core Decompression for Treatment of Canine Femoral Head Osteonecrosis Induced by Arterial Ischaemia and Venous Congestion

2017 ◽  
Vol 27 (4) ◽  
pp. 406-411 ◽  
Author(s):  
Yupeng Liu ◽  
Dewei Zhao ◽  
Weiming Wang ◽  
Yao Zhang ◽  
Benjie Wang ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Vein ◽  
Core Decompression ◽  
Venous Congestion ◽  
Femoral Head Osteonecrosis ◽  
Mixed Breed ◽  
Measurement Time Point ◽  
To Receive ◽  
Poor Efficacy ◽  
Time Point

Methods 40 healthy mixed-breed dogs were randomly divided into 2 groups, arterial ischaemia (AI) and venous congestion (VC), each containing 20 dogs. The dogs underwent a procedure where the deep femoral artery or deep femoral vein was ligated randomly on the left or right side to establish the femoral head osteonecrosis model. 13 dogs from each group, AI and VC, were randomly selected for subsequent study. 3 dogs were randomly chosen from each group to receive core decompression (CD) every 2 weeks for a total of 4 sessions. Results The development of femoral head osteonecrosis was slightly slowed at each measurement time point after CD in the arterial ischaemia (AI) group, but no restoration was observed. The venous congestion (VC) group showed a gradually reduced mixed signal after CD and exhibited a trend towards restoration. The various VC subgroups had significantly improved symptoms compared to the AI subgroups. Conclusions CD displayed greater treatment efficacy for femoral head osteonecrosis caused by VC, but poor efficacy for femoral head osteonecrosis caused by AI.

Early Results of Core Decompression and Autologous Bone Marrow Mononuclear Cells Instillation in Femoral Head Osteonecrosis

2012 ◽  
Vol 27 (5) ◽  
pp. 679-686 ◽  
Author(s):  
Ramesh Kumar Sen ◽  
Sujit Kumar Tripathy ◽  
Sameer Aggarwal ◽  
Neelam Marwaha ◽  
Ratti Ram Sharma ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Mononuclear Cells ◽  
Core Decompression ◽  
Autologous Bone Marrow ◽  
Bone Marrow Mononuclear Cells ◽  
Femoral Head Osteonecrosis ◽  
Early Results ◽  
Autologous Bone

Core decompression isolated or combined with bone marrow-derived cell therapies for femoral head osteonecrosis

2020 ◽  
pp. 1-8
Author(s):  
Filippo Migliorini ◽  
Nicola Maffulli ◽  
Jörg Eschweiler ◽  
Markus Tingart ◽  
Alice Baroncini
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Core Decompression ◽  
Cell Therapies ◽  
Femoral Head Osteonecrosis

Physical Therapy Alone Compared with Core Decompression and Physical Therapy for Femoral Head Osteonecrosis in Sickle Cell Disease

2006 ◽  
Vol 88 (12) ◽  
pp. 2573-2582 ◽  
Author(s):  
Lynne D. Neumayr ◽  
Christine Aguilar ◽  
Ann N. Earles ◽  
Harry E. Jergesen ◽  
Charles M. Haberkern ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Femoral Head ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Core Decompression ◽  
Cell Disease ◽  
Femoral Head Osteonecrosis

Free Vascularized Fibular Grafting Following Failed Core Decompression for Femoral Head Osteonecrosis

2007 ◽  
Vol 22 (5) ◽  
pp. 679-688 ◽  
Author(s):  
Zoe H. Dailiana ◽  
Alison P. Toth ◽  
Eunice Gunneson ◽  
Keith R. Berend ◽  
James R. Urbaniak
Keyword(s):  
Femoral Head ◽  
Core Decompression ◽  
Femoral Head Osteonecrosis ◽  
Fibular Grafting ◽  
Free Vascularized Fibular Grafting

scholarly journals OUTCOMES OF CORE DECOMPRESSION WITH INJECTION OF BONE MARROW ASPIRATE FOR PEDIATRIC FEMORAL HEAD OSTEONECROSIS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0028
Author(s):  
Myles Atkins ◽  
Josny Thimothee ◽  
Tyler McDonald ◽  
Patrick Wright ◽  
Jaysson T. Brooks
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Pediatric Patients ◽  
Bone Marrow Aspirate ◽  
Slipped Capital Femoral Epiphysis ◽  
Core Decompression ◽  
Femoral Head Collapse ◽  
Femoral Head Osteonecrosis ◽  
Text Figure ◽  
Stulberg Classification

Background: Pediatric patients with femoral head osteonecrosis (FHON) often suffer from significant pain with decreased mobility. Once femoral head collapse occurs, few options are available short of a total hip arthroplasty (THA).[1,2] Core decompression by drilling of the femoral head is used to improve pain and prevent further femoral head collapse, however most of the literature on this technique involves adult patients.[3-5] Purpose: To date, there is no description of this technique or its outcomes in pediatric patients with FHON secondary to other etiologies other than sickle cell disease (SCD).[6] The purpose of our study is to determine outcomes in patients with FHON after undergoing core decompression with injection of bone marrow aspirate (BMA). Methods: A retrospective chart review was performed of all pediatric patients at our institution between 2007-2019 with FHON that underwent core decompression with injection of BMA. The following etiologies were identified: SCD, steroid-induced, Perthes disease (PD), slipped capital femoral epiphysis (SCFE), trauma, idiopathic, or other. To determine if core decompression with injection results in cessation of further femoral head collapse, two outcomes were assessed: Stulberg classification and number of cases that required THA. Furthermore, we evaluated whether core decompression with injection occurred in combination with any additional surgical procedure. Results: Twenty-six hips with FHON were identified with the following etiologies: 12 SCD (46.3%), 8 steroid-induced (30.8%), 2 PD (7.7%), 1 SCFE (3.8%), 1 trauma (3.8%), 1 idiopathic (3.8%), 1 other (3.8%). Mean age at the time of surgery was 12.7 years (range: 8-18). Twenty hips (76.9%) were seen in males and 6 (23.1%) were seen in females. Twenty-two hips (84.6%) were seen in black patients and 4 (15.4%) in white patients. Mean follow-up was 37.9 months (range: 0.6-77.8). Mean Stulberg classification was 3.15 (SD: 1.26). Twelve hips (46.2%) required concomitant femoral and/or pelvic osteotomies while 14 hips (53.8%) underwent core decompression with injection alone. Six hips required conversion to THA after initial core decompression and injection. All hips requiring THA were seen in patients with core decompressions and injections but no additional femoral and/or pelvic osteotomies. Conclusion: Most hips undergoing core decompression with injection did not require THA. Of the hips that required THA, all were seen in patients who only had core decompression and injection of BMA but no concomitant femoral and/or pelvic osteotomies. [Figure: see text][Figure: see text][Figure: see text]

A Curved-Drilling Approach in Core Decompression of the Femoral Head Osteonecrosis Using a Continuum Manipulator

2017 ◽  
Vol 2 (3) ◽  
pp. 1480-1487 ◽  
Author(s):  
Farshid Alambeigi ◽  
Yu Wang ◽  
Shahriar Sefati ◽  
Cong Gao ◽  
Ryan. J. Murphy ◽  
...  
Keyword(s):  
Femoral Head ◽  
Core Decompression ◽  
Femoral Head Osteonecrosis ◽  
Continuum Manipulator

scholarly journals Hip-preserving surgical treatment for atraumatic femoral head necrosis

2020 ◽  
Vol 26 (4) ◽  
pp. 495-501
Author(s):  
A.E. Murzich ◽  
◽  
O.A. Sokolovsky ◽  
G.A. Uryev ◽  
◽  
...  
Keyword(s):  
Femoral Head ◽  
Minimally Invasive ◽  
Bone Grafting ◽  
Young Patients ◽  
Core Decompression ◽  
Autologous Bone Marrow ◽  
Femoral Head Necrosis ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Femoral Head Osteonecrosis

Introduction Hip-salvage treatment in femoral head necrosis has a great social and economic importance.The number of hip joint replacements in young patients has been increasing. Purpose To evaluate the results of hip-preserving surgical interventions in the treatment of patients with non-traumatic femoral head necrosis. Materials and methods The study included 42 cases treated by minimally invasive core decompression of the femoral head and bone grafting, 22 cases of decompression and introduction of autologous bone marrow and mesenchymal stem cells into the core of necrosis, and six cases of using a titanium locking mesh implant. Results The follow-up time after surgery was up to 5 years. The survival rate of hip-reserving operations using cell technology to stimulate osteoregeneration were noticeably better than using bone grafting only in disease stages I, IIA, IIB, IIC. For femoral head osteonecrosis in stage IIIA, a titanium locking femoral head implant has been developed. It promotes regeneration and performs a supporting function. Conclusion The analysis of long-term results of these minimally invasive technologies has proven their efficacy and safety along with a low rate of complications.

scholarly journals A Comprehensive Rehabilitation of a known Case of Leprosy Operated for Midshaft Femur Fracture

2021 ◽  
pp. 299-306
Author(s):  
Laukik Vaidya ◽  
Dushyant Bawiskar ◽  
Prateek Upadhyay ◽  
Pratik Phansopkar
Keyword(s):  
Femoral Head ◽  
Femur Fracture ◽  
Core Decompression ◽  
Drug Regimen ◽  
Lower Limbs ◽  
Therapeutic Interventions ◽  
Decompression Surgery ◽  
Femoral Head Osteonecrosis ◽  
Comprehensive Rehabilitation ◽  
Vessel Development

Background: A persistent infection triggered by Mycobacterium leprae is also known as leprosy or Hansen's disease, transmitting by tiny droplets of the nose and mouth to the skin and peripheral nerves, producing disability. Leprosy therapy is based on the combination of the rifampicin, dispone and clofazimine (MDT) three-drug regimen. In patients who undergo hormone therapy, avascular femoral necrosis (ANFH) or femoral head osteonecrosis (ONFH) may occur, causing steroid-induced femoral head avascular necrosis (SANFH) Core decompression (CD) reduces bone pressure, opens the hardening area, prevents osteonecrosis repair, promotes blood vessel development through the tunnel for decompression, increases bone replacement and delays osteonecrosis. Patient information, diagnosis and therapeutic interventions: In this case, we found a 20 years old girl known case of leprosy, was on corticosteroids for two and half years. After an increase in dosage of corticosteroids she began difficult for her walk and do her activities of daily living. She visited Acharya Vinoba Bhave Rural Hospital (AVBRH), DMIMS (DU) Sawangi Meghe, Wardha, Maharashtra, India where she got to know about necrosis of head of femur of both lower limbs. She underwent core decompression surgery of bilateral femoral head. For further management she was referred to Physiotherapy Department. Outcomes and Conclusion:  this case, we found that a patient who is young who had Midshaft femur fracture with interlock nailing and sever kinesiophobia, affecting rehabilitation, was able to resume her ADLs independently.

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