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Acta Orthop Belg 2021 Mar;87(1):25-34

Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. Read More

BMC Musculoskelet Disord 2021 Jun 12;22(1):535. Epub 2021 Jun 12.

Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, #37 Guoxue Road, Chengdu, Sichuan Province, 610041, People's Republic of China.

Background: To determine whether multiple drilling is effective in postponing the need for total hip arthroplasty (THA) in early-stage nontraumatic osteonecrosis of the femoral head (ONFH).

Methods: We identified 514 patients who were diagnosed with early-stage ONFH between January 2008 and December 2018. One hundred ninety-six patients underwent multiple drilling, and 318 patients had a natural course of progression. Read More

J Orthop Surg Res 2021 Jun 9;16(1):369. Epub 2021 Jun 9.

LANS Medicum Hamburg - Center for Sports and Regenerative Medicine, Stephansplatz 5, 20354, Hamburg, Germany.

Background: Extracorporeal shock wave therapy (ESWT) has been used for various pathologies associated with bone marrow oedema (BME). However, it is still not clear whether ESWT may be favourable in the treatment of BME. Therefore, the aim of this systematic review was to assess the efficacy of ESWT for the treatment of BME. Read More

IDCases 2021 23;25:e01170. Epub 2021 May 23.

Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, United States.

Prosthetic joint infection (PJI) is a serious complication of prosthetic joint implantation with a prevalence of about 1-2 % of all prosthetic joint surgeries. While spp. are the most common organisms isolated, . Read More

J Arthroplasty 2021 May 21. Epub 2021 May 21.

Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY.

Background: With improved materials and bearing surfaces, the use of total hip arthroplasty (THA) in young patients is increasing. Functional outcomes and activity level are particularly relevant in this higher-demand patient population. There is a paucity of data on patient-reported outcomes and activity levels after THA in extremely young (<21 years old) patients. Read More

FEBS Open Bio 2021 Jun 6. Epub 2021 Jun 6.

Medical Center of Hip, Luoyang Orthopedic-Traumatological Hospital (Orthopedics Hospital of Henan Province), 471002, Henan Province, China.

Trauma-induced osteonecrosis of the femoral head (TIONFH) is characterized by femoral head collapse accompanied by degenerative changes of the hip. We previously reported that miR-93-5p expression is abnormally high in TIONFH patients, but the role of miR-93-5p in the TIONFH process remains unclear. Herein, we investigated the role of miR-93-5p in TIONFH in a rabbit model. Read More

Medicine (Baltimore) 2021 Jun;100(22):e26210

Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang City, Jiangxi Province, China.

Background: Osteonecrosis of the femeral head (ONFH) occurs predominantly in young- and middle-aged people, and the disability rate is high in the late stage of the disease and most patients have to undergo total hip replacement. Clinically, increasing attention is paid to intervening early and middle-stage ONFH so as to delay its progress. Acupuncture and moxibustion (AM) is a unique method for treating ONFH in China. Read More

Regen Med 2021 Jun 2. Epub 2021 Jun 2.

Department of Orthopedic Surgery, Gifu University, Gifu, 501-1194, Japan.

This study aimed to evaluate the 2-year outcomes from a clinical trial of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Sixty-four patients with nontraumatic, precollapse and large ONFHs were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Setting the end point of radiological collapse, we analyzed the joint preservation period of the historical control. Read More

Orthop Surg 2021 Jun 2. Epub 2021 Jun 2.

Department of Orthopaedic Surgery, The First Hospital of Jilin University, Jilin, China.

Objective: To investigate whether the periprosthetic bone environment could be affected by activity during the early rehabilitation period after primary total hip arthroplasty (THA) and to evaluate the safety and efficacy of activity during the early rehabilitation period.

Methods: This random clinical trial was conducted from January 2017 to July 2017. A total of 22 selected patients with advanced osteonecrosis of the femoral head (ONFH) who underwent primary unilateral THA were randomized (1:1) to a high activity level group (HA group) or a low activity level group (LA group). Read More

J Orthop Surg Res 2021 May 31;16(1):353. Epub 2021 May 31.

Medical School of Chinese PLA, Beijing, 100853, China.

Background: Placement of femoral stem in excessive anteversion or retroversion can cause reduced range of motion, prosthetic impingement, and dislocation. The aim of this study was to assess the operative femoral anteversion in patients treated with total hip arthroplasty (THA) and analyze the need of adjusting stem anteversion.

Methods: We retrospectively included 101 patients (126 hips) who underwent cementless THA with a manual goniometer to determine the femoral anteversion between October 2017 and December 2018. Read More

Phys Sportsmed 2021 Jun 7:1-9. Epub 2021 Jun 7.

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Introduction: This study aims to determine whether ESWT (extracorporeal shock wave therapy) affects ONFH (osteonecrosis of femoral head) in clinical outcomes and radiography outcomes.

Method: Two authors independently search the papers on the treatment of femoral head necrosis with extracorporeal shock wave in CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), CSPD (China Science Periodical Database), Pubmed, Embase, and Springer databases. Search period from the inception dates to 2 June 2020 and have no limitations in language; two authors independently conducted a quality evaluation and data extraction for included studies and performed a meta-analysis with data extracted and calculate by using RevMan5. Read More

Surg Technol Int 2021 05 27;38. Epub 2021 May 27.

Medicine Team Leader, Pfizer Inc, Groton, Connecticut.

Introduction: This prospective cohort study (ClinicalTrials.gov identifier: NCT02674386) evaluated the postoperative outcomes of patients who had undergone total joint replacement (TJR) while participating in one of three tanezumab (a nerve growth factor inhibitor) randomized phase 3 osteoarthritis (OA) studies.

Materials And Methods: Eligible patients were those who underwent TJR (knee, hip, or shoulder) at any time during any of three tanezumab randomized phase 3 OA studies. Read More

Int Orthop 2021 May 27. Epub 2021 May 27.

The Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China.

Purpose: Our research developed a novel approach to quantitatively evaluate the boundary of necrotic lesions in osteonecrosis of the femoral head (ONFH) and to explore its diagnostic value in predicting bone collapse of the femoral head.

Methods: A retrospective cross-sectional study was conducted in our institution, and 146 hips (121 cases) identified as ONFH were recruited. The anterior and lateral boundaries of each enrolled subject were measured in standard anteroposterior (AP) view and frog-leg (FL) view of plain radiographic images, the intact rate of which was then calculated and presented as the anteroposterior view intact ratio (APIR) and frog-leg view intact ratio (FLIR), respectively. Read More

J Med Case Rep 2021 May 26;15(1):287. Epub 2021 May 26.

Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, 4200-319, Porto, Portugal.

Background: The clinical characteristics and complications of Cushing syndrome (CS) are well known and described in the literature. Nevertheless, rare, atypical presentations may go unnoticed. Osteonecrosis is a well-documented complication of glucocorticoid therapy. Read More

Eur J Orthop Surg Traumatol 2021 May 24. Epub 2021 May 24.

Department of Orthopaedic Surgery, The Stanford Child and Adult Hip Preservation Center, Stanford University School of Medicine, 450 Broadway Street, Pavilion C, 4th Floor, Stanford, Redwood City, CA, USA.

Purpose: Reconstruction of the acetabular labrum during femoroacetabular impingement (FAI) surgery is accepted when the labrum is deficient and irreparable. Here we describe a novel technique using fresh-frozen medial meniscal allograft for labral reconstruction during surgical hip dislocation for correction of pincer FAI due to acetabular overcoverage.

Methods: The results from seven hips (six patients) that underwent this procedure with 1 year minimum follow-up, and radiographs are presented. Read More

Endocrinol Metab Clin North Am 2021 Jun 28;50(2):193-203. Epub 2021 Apr 28.

Endocrinology and Metabolism Section, Central Virginia Veterans Affairs Health Care System, Richmond, VA, USA; Division of Endocrinology, Virginia Commonwealth University, Richmond, VA, USA. Electronic address:

Bisphosphonates remain a first-line treatment for osteoporosis and decrease vertebral and hip fractures without side effects in most patients. With extended treatment, osteonecrosis of the jaw and atypical femoral fracture occur rarely, but fear of side effects has led to not starting or discontinuing treatment. Atrial fibrillation and uveitis are less appreciated by the general public, but their rare incidence must be recognized. Read More

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 05;52(3):452-457

Gansu University of Chinese Medicine, Lanzhou 730000, China.

Objective: To investigate the difference in the expression of Ras-associated protein 1 (Rap1) in necrotic and healthy areas of non-traumatic osteonecrosis of femoral head (NONFH) patients.

Methods: Femoral head tissue samples from 30 cases of NONFH and 30 cases of traumatic osteonecrosis of the femoral head (TONFH) were collected after hip replacement surgery, respectively. No significant difference of Association Research Circulation Osseous (ARCO) staging was found between the NONFH and the TONFH groups ( =-0. Read More

Injury 2021 May 2. Epub 2021 May 2.

Duke University Hospital, Department of Orthopaedic Surgery, 2310 Erwin Road, Durham, NC 27710, USA. Electronic address:

Introduction: Osteonecrosis of the femoral head (ONFH) can occur after traumatic injuries of the hip. Surgical treatment with total hip arthroplasty (THA) may not produce lifelong viability in younger patients. Free vascularized fibular graft (FVFG) has become a reliable method to delay or even avoid THA in this patient population by aiming to correct loss of viable bone through vascularized autologous bone transfer. Read More

J Orthop Surg Res 2021 May 20;16(1):327. Epub 2021 May 20.

Department of Joint Orthopaedic, the Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.

Background: Steroid-induced osteonecrosis of the femoral head (ONFH) is a common hip joint disease and is difficult to be diagnosed early. At present, the pathogenesis of steroid-induced ONFH remains unclear, and recognized and effective diagnostic biomarkers are deficient. The present study aimed to identify potentially important genes and signaling pathways involved in steroid-induced ONFH and investigate their molecular mechanisms. Read More

J Orthop Surg Res 2021 May 20;16(1):325. Epub 2021 May 20.

Department of Orthopedics, Linyi People's Hospital, Jie Fang Road East, No.27, Linyi, 276003, Shandong Province, China.

Background And Objective: The neuropeptide vasoactive intestinal peptide is a 28-amino acid neuropeptide that has been shown to stimulate bone repair and angiogenesis. The purpose of this study was to explore the potential role of serum VIP concentration in osteonecrosis of femoral trauma (ONFH).

Methods: One hundred five patients diagnosed with non-traumatic ONFH and 103 healthy individuals were enrolled in our study. Read More

Case Rep Orthop 2021 28;2021:5584408. Epub 2021 Apr 28.

Department of Orthopedic Surgery, ENDO-Klinik Hamburg, Holstenstr. 2, 22767 Hamburg, Germany.

. Morquio syndrome or mucopolysaccharidosis (MPS) type IV is a rare autosomal recessive lysosomal storage disease, characterized by abnormal metabolism of glycosaminoglycans associated with specific skeletal deformities, also known as dysostosis multiplex. . Read More

Br Med Bull 2021 Jun;138(1):112-125

Department of Orthopaedics and Trauma Surgery, University Medical Centre Mannheim of the University Heidelberg, 68167 Mannheim, Germany.

Introduction: Osteonecrosis of the femoral head (ONFH) often leads to secondary osteoarthritis and total hip arthroplasty.

Source Of Data: Recent published literatures.

Areas Of Agreement: There has been increasing focus on the early intervention in ONFH patients to preserve the native hip articulation, reduce pain and improve function. Read More

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211012266

Ashland Bellefonte Cancer Center, Ashland, KY, USA.

Fat embolism syndrome is a relatively infrequent presentation in sickle cell thalassemia patients. It most commonly occurs in long bone fractures in the setting of trauma. However, nonorthopedic trauma and nontraumatic cases have been reported to contribute to fat embolism. Read More

Int J Hematol 2021 May 18. Epub 2021 May 18.

Department of Hematology/Oncology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuou-ku, Saitama, 330-8777, Japan.

Osteonecrosis (ON), a long-term complication of acute lymphoblastic leukemia (ALL) treatment affects patients' quality of life. Although the incidence of any ON, including asymptomatic, was 21.7% among children with ALL in the U. Read More

Indian J Orthop 2021 Jun 3;55(3):595-605. Epub 2021 Jan 3.

Spine Fellow, University Hospital for Wales, Cardiff, CF 144XW UK.

Introduction: Delayed reduction of the hip in femoral head fracture dislocation increases the risk of osteonecrosis and adversely affects the functional outcome.

Materials And Methods: This retrospective study was designed to evaluate the outcome and complications of 138 patients with femoral head fracture dislocation treated by a single surgeon over a period of 22 years. Only seven patients presented within 24 h of injury and remaining all presented late. Read More

Arthritis Care Res (Hoboken) 2021 May 10. Epub 2021 May 10.

Pfizer Inc, Groton, Connecticut, USA.

Objective: This pooled analysis of 3 randomized, placebo-controlled trials (16─24 week treatment; 8─24 week follow-up) assessed safety of subcutaneous tanezumab (2.5─10 mg every 8 weeks) in 1840 patients with hip or knee osteoarthritis.

Methods: Overall treatment-emergent adverse events (TEAEs) and TEAEs of abnormal peripheral sensation (APS) were prospectively assessed in 3 trials. Read More

Arthroscopy 2021 May 5. Epub 2021 May 5.

Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.

Purpose: To assess whether biologic augmentation in addition to core decompression (CD), compared with CD alone, improves clinical and radiographic outcomes in the treatment of nontraumatic osteonecrosis of the femoral head (ONFH). Our hypothesis was that biologic augmentation would reduce the progression of osteonecrosis and therefore also the rate of conversion to total hip arthroplasty (THA).

Methods: A systematic review was performed in accordance with the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. Read More

J Hip Preserv Surg 2020 Aug 29;7(3):466-473. Epub 2020 Oct 29.

Department of Anesthesiology, Aichi Children's Health and Medical Center, Cincinnati, Ohbu City, Aichi 474-8710, Japan.

The Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) was created for patient-reported outcome measures (PROMs) and to evaluate the conditions of patients with hip disease. Nevertheless, the validity of the JHEQ for patients with hip labral tears remains unclear. Therefore, we validated the JHEQ in patients with labral tears. Read More

J Hip Preserv Surg 2020 Aug 23;7(3):458-465. Epub 2020 Dec 23.

Department of Orthopaedics & Orthopaedic Surgery, Saarland University, Kirrberger Strasse 100, Homburg 66421, Germany.

This study's purpose is to arthroscopically assess the occurrence of intraarticular pathologies in patients with osteonecrosis of the femoral head (OFNH) and to compare arthroscopic with radiologic findings. In a retrospective cohort analysis of ONFH patients undergoing combined core decompression (CD) and hip arthroscopy, concomitant intraarticular pathologies were qualitatively and quantitatively assessed by means of arthroscopy. Intraoperative findings were compared with preoperative radiodiagnostics. Read More