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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

MRIs of the left hip before and after treatment showing resolution of bone marrow edema and no further collapse of the femoral heads (Arrow).
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fig6: MRIs of the left hip before and after treatment showing resolution of bone marrow edema and no further collapse of the femoral heads (Arrow).

Mentions: Table 4 summarizes the results of radiographic and MRI evaluations before and after treatment. There was a trend of decrease in the size of the lesion after ESWT (Figures 4 and 5). However, the differences were not statistically significant (P > 0.05). It was easier to visualize the bone marrow edema in MRI of ONFH in non-LPFH group (205/376 hips, 54.5%) than in LPFH group (130/152 hips, 85.5%). A significant reduction in bone marrow edema was observed after treatment (P < 0.05) (Figure 6). The reduction in bone marrow edema correlated with clinical improvement in pain and function of the hip [18]. The imaging studies showed stable images of the hip, including the obvious osteogenesis signs of the femoral head, absence of progress in osteonecrosis staging, and significantly improved concomitant bone marrow edema (Table 4).


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)

MRIs of the left hip before and after treatment showing resolution of bone marrow edema and no further collapse of the femoral heads (Arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig6: MRIs of the left hip before and after treatment showing resolution of bone marrow edema and no further collapse of the femoral heads (Arrow).
Mentions: Table 4 summarizes the results of radiographic and MRI evaluations before and after treatment. There was a trend of decrease in the size of the lesion after ESWT (Figures 4 and 5). However, the differences were not statistically significant (P > 0.05). It was easier to visualize the bone marrow edema in MRI of ONFH in non-LPFH group (205/376 hips, 54.5%) than in LPFH group (130/152 hips, 85.5%). A significant reduction in bone marrow edema was observed after treatment (P < 0.05) (Figure 6). The reduction in bone marrow edema correlated with clinical improvement in pain and function of the hip [18]. The imaging studies showed stable images of the hip, including the obvious osteogenesis signs of the femoral head, absence of progress in osteonecrosis staging, and significantly improved concomitant bone marrow edema (Table 4).

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