BIORESORBABLE MATERIALS FOR BONE DEFECTS SUBSTITUTION IN PATIENTS WITH OSTEONECROSIS OF THE FEMORAL HEAD

Cover Page


Cite item

Full Text

Abstract

Osteonecrosis of the femoral head is one of the serious diseases of the hip. The outcome of the disease is the development of osteoarthritis of the hip in patients of working age. Today, one of the most popular surgical procedures in the early stages of the disease remains a core decompression. The purpose of the study was to understand the efficacy and safety of core decompression and filling bone defect bioresorbable materials. Material and methods. From 2006 to 2014 in Vreden Russian Research Institute for Traumotology and Orthopedics 62 patients (79 hips) with different stages of osteonecrosis of the femoral head were treated. In all patients the classical decompression chamber of femoral head osteonecrosis was performed. In 36 patients (48 hips) the decompression was done with no additional processing the chamber, in 25 patients (31 joints) after decompression the treatment of osteonecrosis zone to the healthy bone was performed. In 56 cases the bioresorbable granular material based on calcium sulfate was used for filling the defect, in 6 cases - β-3 calcium phosphate, in 17 cases - the bioresorbable material based on the combination of calcium sulfate and 3 ß-calcium phosphate. Results. In the mean follow-up of 26.9 (6 to 62) months, the overall survival rate was 54.4%. In patients with the second stage of the disease the arthroplasty was performed only in 17.6% of cases, while in patients with the fourth stage - in 100%. In the third stage of osteonecrosis a strong correlation of survival with the necrosis volume was observed. Conclusion. The success of surgical interventions directly depended on the stage of the process, volume and fullness of osteonecrosis zone, as well as on the type of bioresorbable material and fullness of bone defect filling.

About the authors

V. A. Konev

Vreden Russian Research Institute for Traumotology and Orthopedics

Author for correspondence.
Email: vladimirkonev24@mail.ru
Russian Federation

R. M. Tikhilov

Vreden Russian Research Institute for Traumotology and Orthopedics; Mechnikov NorthWestern State Medical University

Email: info@rniito.org
Russian Federation

I. I. Shubnyakov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: shubnyakov@mail.ru
Russian Federation

A. A. Myasoedov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: myasoedov_alexei@mail.ru
Russian Federation

A. O. Denisov

Vreden Russian Research Institute for Traumotology and Orthopedics

Email: med-03@yandex.ru
Russian Federation

References

  1. Зоря В.И. Возможные причины асептического некроза головки бедренной кости у взрослых и вопросы его диагностики. Травматология и ортопедия России. 1994; (5):46-53
  2. Корж А.А. Керамические имплантаты при хирургическом лечении асептического некроза головки бедренной кости. Ортопедия, травматология и протезирование. 1989; (10):1-3
  3. Тихилов Р.М., Шубняков И.И., Коваленко А.Н., Черный А.Ж., Муравьева Ю.В., Гончаров М.Ю. Данные регистра эндопротезирования тазобедренного сустава РНИИТО им. Р.Р. Вредена за 2007 - 2012 годы. Травматология и ортопедия России. 2013; 93):167-190
  4. Aldridge J.M. Free vascularized fibular grafting for the treatment of postcollapse osteonecrosis of the femoral head. Surgical technique. J. Bone Joint Surg. Am. 2004; 86-A, Suppl. 1:87-101.
  5. Baroud G., Cayer E., Bohner M. Rheological characterization of concentrated aqueous beta-tricalcium phosphate suspensions: the effect of liquid-to-powder ratio, milling time, and additives. 2005; 1(3):357-363.
  6. Bohner M. Calcium orthophosphates in medicine: from ceramics to calcium phosphate cements. Injury. 2000; 31 Suppl. 4:37-47.
  7. Drosse I., Volkmer E., Capanna R., De Biase P., Mutschler W., Schieker M. Tissue engineering for bone defect healing: an update on a multi-component approach. Injury. 2008; 39 Suppl. 2:S9-20.
  8. Gangji V., Hauzeur J.P., Matos C., De Maertelaer V., Toungouz M., Lambermont M. Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells: A pilot study. J Bone Joint Surg Am. 2004;86:1153-60.
  9. Gardeniers J.W.M. ARCO Report of the committee of staging and nomenclature. ARCO News Letter. 1993; 5: 79-82.
  10. Hernigou P., Manicom O., Poignard A., Nogier A., Filippini P., Abreu L.D. Core decompression with marrow stem cells. Oper. Tech. Orthop. 2004; 14:68-74.
  11. Hernigou P., Poignard A., Manicom O., Mathieu G., Rouard H. The use of percutaneous autologous bone marrow transplantation in nonunion and avascular necrosis of bone. J. Bone Joint Surg. Br. 2005; 87:896-902.
  12. Keizer S.B., Kock N.B., Dijkstra P.D., Taminiau A.H., Nelissen R.G. Treatment of avascular necrosis of the hip by a non-vascularised cortical graft. J. Bone Joint Surg. Br. 2006; 88:460-466.
  13. Lieberman J.R., Berry D.J., Mont M.A., Aaron R.K., Callaghan J.J., Rajadhyaksha A.D., Urbaniak J.R. Osteonecrosis of the hip: management in the 21st century. Instr. Course. Lect. 2003; 52:337-355.
  14. Mont M.A., Hungerford D.S. Non-traumatic avascular necrosis of the femoral head. J. Bone Joint. Surg. Am. 1995; 77:459-474.
  15. Mont M.A., Carbone J.J., Fairbank A.C. Core decompression vs. non-operative management for avascular necrosis of the femoral head. Clin. Orthop. 1996; (324):169-178.
  16. Mont M.A., Einhorn T.A., Sponseller P.D., Hungerford D.S. The trapdoor procedure using autogenous cortical and cancellous bone grafts for osteonecrosis of the femoral head. J. Bone Joint Surg. Br. 1998; 80:56-62.
  17. Nishii T. Progression and cessation of collapse in osteonecrosis of the femoral head. Clin. Orthop. 2002; (400):149-157.
  18. Shuler M.S., Rooks M.D., Roberson J.R. Porous tantalum implant in early osteonecrosis of the hip preliminary report on operative, survival and outcomes results. J. Arthroplasty. 2007; 22:26-31.
  19. Silveira R.L., Silveira R.L., Machado R.A., Silveira C.R., Oliveira R.B. Bone repair process in calvarial defects using bioactive glass and calcium sulfate barrier. Acta Cir. Bras. 2008; 23(4):322-328.
  20. Stein H., Volpin G., Horer D. Vascularized musclepedicle flap for osteonecrosis of the femoral head. Orthopedics. 2002; 25:485-488.
  21. Veillette C.J., Mehdian H., Schemitsch E.H., McKee MD. Survivors hip analysis and radiographic outcome following tantalum rodinsertion for osteonecrosis of the femoral head. J. Bone Joint Surg. Am. 2006; 88:48-55.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c)



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies