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PubMedDate not supplied

Experience with steroid-induced avascular necrosis of the shoulder and etiologic considerations regarding osteonecrosis of the hip.

Nineteen of 97 patients with steroid-induced osteonecrosis had a lesion involving the head of the humerus, on one or both sides. The lesion usually began as a subchondral osteolytic area which often progresses to collapse. Articular cartilage separated from subchondral bone, either becoming detached as a free cap or at a later stage reattaching. Present evidence suggests that osteonecrosis of the femoral or humeral head should properly be classified as either traumatic (macrovascular injury) or embolic (microvascular injury) in nature. In 14 patients conservative treatment resulted in satisfactory function with only intermittent symptoms, and including pendulum exercises and avoidance of abduction, particularly against resistance. Five patients required replacement of 6 humeral head replacement arthroplasties with Neer's prosthesis.

Female↗

PubMed1978

Osteonecrosis of the knee. A clinicopathological study in twenty-eight patients.

Specimens from thirty-four knees in twenty-eight patients with histologically proved osteonecrosis were reviewed. Twelve knees had the clinical diagnosis of so-called idiopathic osteonecrosis; eight, osteoarthrosis; and fourteen, rheumatoid arthritis. Pathologically, the necrosis was localized in the subchondral region of the medial femoral condyle in 67 per cent of the knees. There were pathological fracture and collapse and fragmentation of the necrotic segment leading to marked deformities in most cases. The response to necrosis consisted of histiocytic resorption of necrotic material and formation of granulation tissue and reactive new bone surrounding it. The response was relatively less prominent in the knees with degenerative joint disease and rheumatoid arthritis.

Aged↗

PubMedDate not supplied

The treatment of osteonecrosis of the hip with fresh osteochondral allografts and with the muscle pedicle graft technique.

Osteonecrosis of the hip in Stages 1 and 2 are treated by conservative measures such as rest, aspirin, and a cane. If activities of daily living are impaired or stronger analgesics become necessary the muscle pedicle graft is advised. Fresh osteochondral grafts are utilized to resurface the head of the femur in Stages 3 and 4 in vigorous patients below the age of 60 when strong analgesics are required to relieve pain. A total hip arthroplasty is the treatment of choice for all patients in Stage 5 or those beyond the age of 60 in Stages 3 and 4. Five patients have had allografts; all are doing well. Three have been followed over 2 years, one over one and one-half years, and the other over 6 months. Twenty-three patients have had muscle pedicle grafts. The results have been good in the 8 patients in Stages 1 and 2. Only 5 of the 15 patients with osteonecrosis in Stages 3 and 4 have had good results.

Adult↗

PubMedDate not supplied

Epidemiology of traumatic and nontraumatic osteonecrosis.

In reviewing the epidemiology of traumatic and nontraumatic osteonecrosis the only common denominator appears to be that of circulatory compromise. Causative mechanisms seem to be quite distinct. A number of factors may predispose to postfracture hip necrosis, i.e. the type of fracture, the quality of reduction and union of the fracture. For postdislocation necrosis, causative factors include the type of dislocation as well as the timing and nature of the reduction. For nontraumatic osteonecrosis, an array of consistently associated systemic disorders appears to be largely linked by frequent lipid elevations. Alcoholism and corticosteroid use account for the bulk of cases and there is consistent predisposition to males and bilateral involvement. Multifocal lesions attest to the systemic basis for this form of necrosis.

Adult↗

PubMed1976

[Induced hyperlipemia test during femur head osteonecrosis].

The authors studied disturbances of lipid clearance in cases of aseptic osteonecrosis of the femoral head by means of an induced intravenous hyperlipemia test. With reference to investigations in 19 patients, the authors first draw attention to the frequency of ethylism and of fatty degeneration of the liver (13 patients). A significant decrease was noted in the coefficient of lipid clearance in the 19 patients. This was particularly marked when fatty degeneration of the liver was present. The etiological role of these anomalies should be considered, as fatty degeneration and hyperlipaemia may also be found in other pathological conditions responsible for primary osteonecrosis of the femoral head (corticotherapy).

Adult↗

PubMed1979

[Symptoms and therapy of spontaneous osteonecrosis of the medial femoral condyle in elder patients (author's transl)].

The author reports on symptoms, therapy and results of a follow-up of 17 patients with the rare disease of osteonecrosis of the medial femoral condyle. The therapy depends on the extend of the necrosis, the axis of the leg and the results of scintigraphy or scintimetry and arthrography or arthroscopy. Small necroses can be treated conservatively, but in case of a genu varum a valgus-osteotomie should be performed. Bigger necroses are bored or bolted combined with a valgus-osteotomie, if necessary. Extensive osteonecroses can only be treated by partial endoprosthesis or autologue bone-cartilage-transplantation.

Aged↗

PubMed2026

A Novel Long Noncoding RNA-LNC000133 Associated With Steroid-Induced Osteonecrosis of the Femoral Head Promotes Osteoblast Differentiation Through Bone Marrow Mesenchymal Stem Cells-Derived Exosomes Pathway: A Bioinformatics Validation and Detailed Mechanistic Study.

Steroid-induced osteonecrosis of the femoral head (SONFH) is a debilitating disease caused by glucocorticoid abuse, characterized by complex pathogenesis and unclear molecular mechanisms. Dysfunction of bone marrow mesenchymal stem cells (BMSCs) and their exosome-mediated signalling is a key contributor to SONFH, although the precise mechanisms remain to be elucidated. In this study, the differential expression profiles of long noncoding RNAs (lncRNAs), microRNAs (miRNAs) and messenger RNAs (mRNAs) in exosomes derived from human BMSCs (hBMSCs) obtained from patients with SONFH compared to controls with femoral neck fractures were identified. Through next-generation sequencing, a novel lncRNA, LNC000133, associated with SONFH was discovered. Using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and competing endogenous RNA (ceRNA) network construction, the LNC000133/miR-362-5p/TGF-β3/SMAD3/BMP2 signalling axis was established. The definitive expression, localization and full-length sequence of LNC000133 in BMSCs were subsequently validated by Northern blot, quantitative real-time polymerase chain reaction (qRT-PCR), fluorescence in situ hybridization (FISH) and rapid amplification of cDNA ends (RACE). Most notably, mechanistic studies demonstrated that LNC000133-modified BMSCs-derived exosomes were efficiently taken up by osteoblasts, which promoted proliferation and osteogenic differentiation by targeting the miR-362-5p/TGF-β3/SMAD3/BMP2 signalling pathway.

Humans↗

PubMed1978

Osteonecrosis in Hodgkin's disease.

Four patients suffering from Hodgkin's disease developed osteonecrosis following therapy and both femoral heads were involved in each case. Retrospective review of abdominal radiographs taken for follow-up lymphography demonstrated that the earliest radiological changes in bone were evident between five and 18 months after treatment was started and between six and 21 months before the onset of symptoms. The clinical implications are discussed.

Adult↗

PubMed1976

Spontaneous osteonecrosis of the medial femoral condyle.

Six patients with osteonecrosis of the medial femoral condyle were seen during a 3 1/2-year period in a rheumatology unit. This condition, which may not be rare, is characterized by the sudden onset of pain in the knee of elderly people (usually women) without significant trauma. Physical signs include effusion and tenderness at the medial margin of the knee joint. Radiographic changes may not be evident for weeks or even months. The later appearances are characteristic and the site of the lesion is remarkably constant.

Aged↗

PubMedDate not supplied

[Anesthesia and resuscitation in surgery for aseptic osteonecrosis in patients with renal transplants].

Aseptic osteonecrosis following renal transplantation occurs in about 20 p. 100 of cases and entails important functional consequences. 16 patients with kidney transplant and 4 patients on chronic dialysis because of previous graft rejection underwent 27 orthopaedic operations, 8 of which being hip arthroplasties. During and after the procedure the anesthesiologist had to manage with drug interaction, coagulation disorders, blood compatibility problems etc... Despite poor general condition of patients and the risk of infectious complications linked to the never interrupted immunosupressive treatment, the surgical results of our serial were good.

Adolescent↗

PubMed1979

[Spontaneous Ahlbäck's knee joint osteonecrosis].

Among the group of genuine osteonecroses there ranks the spontaneous osteonecrosis of the knee described for the first time by Ahlbäck, Bauer and Bohne in 1968. Characteristic of it is a subchondral defect on the medial condylus of the femur, which may occur in old persons, chiefly women. Supported by six illustrative cases in own patients clinical experience, radiology, diagnosis and differential diagnosis are presented and discussed.

Aged↗

PubMedDate not supplied

Bone collagen in dysbaric osteonecrosis.

Experimental dysbaric osteonecrosis associated with inadequate decompression has been induced in mature female swine. The bone collagen from the radiologically defined lesion in the femur has been analyzed. The total collagen contents were the same for the epiphyseal (F-1), the metaphyseal (F-2), and the diaphyseal (F-3) regions. Soluble bone collagen content obtained by sequential extraction of the samples with acetic acid urea, guanidine, lithium chloride and potassium thiocyanate, decreased by approximately 20% in going from the F-1 to the F-2 to the F-3 regions for both experimental and control samples. The amino acid compositions and acrylamide gel electrophoresis patterns were the same for control and experimental samples. Spectral changes with the MBTH reaction were different for control and experimental collagen samples from all bone regions. The spectral shift and pattern changes which occurred from pH 4 to pH 1 suggested a higher average content of unsaturation in the collagen associated aldehyde groups in the experimental than in the control samples. These findings suggest an enhanced ability to remodel collagen which would be consistent with the histological observation of increased derangement of collagen fibers in the experimental bone samples.

Aldehydes↗

PubMedDate not supplied

Scintigraphy in the diagnosis of osteonecrosis.

Scintigraphy, using 99mTc diphosphonate, has the potential for diagnosing osteonecrosis before irreversible changes are visible in routine roentgenograms. If obtained within weeks of an avascular insult, a cold area will appear on scintiscan. However, months later, the revascularization and reparative processes of the dead bone produce a hot area on scintiscan.

Femur Head Necrosis↗

PubMedDate not supplied

[Osteonecrosis in drepanocytemia (author's transl)].

Aseptic osteonecrosis is due to local hypoxemia related to the sickling process. Its frequency in the U.S.A. is 8,5 p. 100 for heterozygotic patients and 0,2 p. 100 for homozygotic ones. It is rare in AS status but frequent in the double heterozygotism SC. Alcoholism, hyperlipidemia, hyperuricemia, cortisonic treatments and pregnancy are facilitating factors. For vascular causes the femoral epiphysises are most often affected. Radiological features are described.

Anemia, Sickle Cell↗

PubMed1977

Serum ferritin and dysbaric osteonecrosis.

Bone and marrow necrosis has been produced in rabbits. Changes in serum ferritin levels have been measured (with appropriate controls). Results suggest that marrow death is followed by a significant rise in serum ferritin levels. The possiblitiy that this may be of value in the early diagnosis of dysbaric osteonecrosis is discussed.

Animals↗

PubMed1977

Preliminary report of total ankle arthroplasty for osteonecrosis of the talus.

Osteonecrosis of the talus secondary to adrenal corticosteroids is rare. The pathophysiology of the disorder is controversial. This is a report of bilateral talar necrosis secondary to steroid medications in a 23-year-old male. Conservative methods of management of the condition are not altogether satisfactory. Bilateral ankle replacement in this case resulted in alleviation of pain and improvement of function.

Adult↗

PubMed1979

Osteonecrosis of hyoid bone and thyroid cartilage.

A 55-year-old man with carcinoma of the right pyriform fossa was treated with cobalt therapy. Subsequently, osteonecrosis of the right greater horn and the right superior horn of the thyroid cartilage developed, followed by pathologic fractures of the processes and spontaneous expulsion of the sequestrae.

Carcinoma, Squamous Cell↗

PubMed1975

Osteonecrosis following renal transplantation.

Subarticular osteonecrosis has been described with increasing frequency after renal transplantation and the use of immunosuppressive corticosteroids. Six cases have been encountered among 170 patients in the Johannesburg renal transplantation programme. The commonly affected sites are the femoral head, the femoral condyles, the humeral head, the talus and the capitulum. The radiological and morbid anatomical features of this complication are described, alternative theories of pathogenesis are considered and an approach to treatment is outlined.

Adolescent↗