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High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series.

Gao F, Sun W, Li Z, Guo W, Wang W, Cheng L, Wang B - Evid Based Complement Alternat Med (2015)

Bottom Line: The lesion size decreased after ESWT.A significant reduction in bone marrow edema was observed after treatment (LPFH group, P = 0.007; non-LPFH group, P = 0.016).High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

View Article: PubMed Central - PubMed

Affiliation: Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing 100029, China.

ABSTRACT
Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips) were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips) demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score, P = 0.00006; Harris hip score, P = 0.00091). During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group). The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group, P = 0.091; non-LPFH group, P = 0.087). A significant reduction in bone marrow edema was observed after treatment (LPFH group, P = 0.007; non-LPFH group, P = 0.016). High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

No MeSH data available.


Related in: MedlinePlus

Image of coronal section of the femoral head showing three pillars of the femoral head: lateral (30%), central (40%), and medial (30%) [19].
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fig1: Image of coronal section of the femoral head showing three pillars of the femoral head: lateral (30%), central (40%), and medial (30%) [19].

Mentions: Preoperative clinical evaluations included a complete history and physical examination, laboratory tests including CBC, platelet count, PT, PTT, chemistry profiles, BUN and creatine, EKG and chest X-rays, radiographs, and MRI of the affected hip or hips. All hips were symptomatic on evaluation. The underlying diagnosis was confirmed by X-rays and MRI. All subjects received an MRI evaluation according to China-Japan Friendship Hospital (CJFH) classification [19, 20] (Figures 1 and 2) for osteonecrosis of the femoral head based on three pillars (Figure 1). The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved or not [21] (Table 2). The LPFH group consisted of 376 hips with the preservation of the lateral pillar of the femoral head (including CJFH Types M, C, and L1). The non-LPFH group consisted of 152 hips without the preservation of the lateral pillar of the femoral head (including CJFH Types L2 and L3).


High-Energy Extracorporeal Shock Wave for Early Stage Osteonecrosis of the Femoral Head: A Single-Center Case Series.

Gao F, Sun W, Li Z, Guo W, Wang W, Cheng L, Wang B - Evid Based Complement Alternat Med (2015)

Image of coronal section of the femoral head showing three pillars of the femoral head: lateral (30%), central (40%), and medial (30%) [19].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4644843&req=5

fig1: Image of coronal section of the femoral head showing three pillars of the femoral head: lateral (30%), central (40%), and medial (30%) [19].
Mentions: Preoperative clinical evaluations included a complete history and physical examination, laboratory tests including CBC, platelet count, PT, PTT, chemistry profiles, BUN and creatine, EKG and chest X-rays, radiographs, and MRI of the affected hip or hips. All hips were symptomatic on evaluation. The underlying diagnosis was confirmed by X-rays and MRI. All subjects received an MRI evaluation according to China-Japan Friendship Hospital (CJFH) classification [19, 20] (Figures 1 and 2) for osteonecrosis of the femoral head based on three pillars (Figure 1). The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved or not [21] (Table 2). The LPFH group consisted of 376 hips with the preservation of the lateral pillar of the femoral head (including CJFH Types M, C, and L1). The non-LPFH group consisted of 152 hips without the preservation of the lateral pillar of the femoral head (including CJFH Types L2 and L3).

Bottom Line: The lesion size decreased after ESWT.A significant reduction in bone marrow edema was observed after treatment (LPFH group, P = 0.007; non-LPFH group, P = 0.016).High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

View Article: PubMed Central - PubMed

Affiliation: Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Department of Orthopedic Surgery, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing 100029, China.

ABSTRACT
Our retrospective study assessed the effects of treatment of early stage ONFH with extracorporeal shock wave therapy. 335 patients (528 hips) were treated with shockwave therapy in our institution. Each patient underwent two sessions. The hips were divided into two groups according to whether the lateral pillar of the femoral head (LPFH) was preserved: LPFH and non-LPFH groups. Patients were followed up at 3, 6, and 12 months after the treatment. Most of the patients (83.9% hips) demonstrated pain reduction and improved mobility of the treated joint (visual analogue scale score, P = 0.00006; Harris hip score, P = 0.00091). During the follow-up period, 16 hips failed following femoral head collapse and required hip arthroplasty (2 hips in LPFH group and 14 hips in non-LPFH group). The lesion size decreased after ESWT. However, the differences were statistically not significant (LPFH group, P = 0.091; non-LPFH group, P = 0.087). A significant reduction in bone marrow edema was observed after treatment (LPFH group, P = 0.007; non-LPFH group, P = 0.016). High-energy extracorporeal shock wave therapy resulted in considerable improvement in early stage ONFH, which can effectively relieve pain and improve the function of the hip.

No MeSH data available.


Related in: MedlinePlus