A summary of hip-preservation surgery based on peri-collapse stage of osteonecrosis of femoral head_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Yuhao ^1,2 , ZHOU Chi ^2,3,4 , CHEN Leilei ^2,3,4 , SUN Youqiang ^1,2 ,  HE Wei ^2,3,4

1. First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China;
2. The Lab of Orthopaedics and Traumatology, Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China;
3. Department of Joint Orthopaedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China;
4. National Chinese Medicine Key Specialist of Hip Disease, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China;

Corresponding author：

HE Wei, Email: hw13802516062@126.com

Keywords：

Osteonecrosis of the femoral head; Peri-collapse stage; Hip-preservation surgery

DOI：

10.7507/1002-1892.201611084

Video：

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Objective To summarize surgical procedures of hip-preservation based on peri-collapse stage of osteonecrosis of the femoral head (ONFH). Methods The basic points of peri-collapse stage theory was expounded. The related literature on surgical procedures was summarized and analyzed based on the theory. Results Surgical procedures of hip-preservation tend to emphasize on mechanical repair, giving consideration to biological repair. It is consistent with the essence of peri-collapse stage theory, which attaches great importance to biomechanical stability. Conclusion Peri-collapse stage theory has a guiding significance to the choice of surgical timing and approach, and it is one of the important theoretical basis for hip-preservation treatment.

Citation： LIU Yuhao, ZHOU Chi, CHEN Leilei, SUN Youqiang, HE Wei. A summary of hip-preservation surgery based on peri-collapse stage of osteonecrosis of femoral head. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 1010-1015. doi: 10.7507/1002-1892.201611084 Copy

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2.	Mont MA, Cherian JJ, Sierra RJ, et al. Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today? A Ten-Year Update. J Bone Joint Surg (Am), 2015, 97(19): 1604-1627.
3.	Nam KW, Kim YL, Yoo JJ, et al. Fate of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg (Am), 2008, 90(3): 477-484.
4.	Zhang NF, Li ZR, Wei HY, et al. Steroid-induced osteonecrosis: the number of lesions is related to the dosage. J Bone Joint Surg (Br), 2008, 90(9): 1239-1243.
5.	Nagasawa K, Tada Y, Koarada S, et al. Very early development of steroid-associated osteonecrosis of femoral head in systemic lupus erythematosus: prospective study by MRI. Lupus, 2005, 14(5): 385-390.
6.	何伟. 如何把握股骨头坏死患者的保髋治疗时机. 中国骨与关节杂志, 2016, 5(2): 82-86.
7.	Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association. Guideline for Diagnostic and Treatment of Osteonecrosis of the Femoral Head. Orthop Surg, 2015, 7(3): 200-207.
8.	Etienne G, Mont MA, Ragland PS. The diagnosis and treatment of nontraumatic osteonecrosis of the femoral head. Instr Course Lect, 2004, 53: 67-85.
9.	崔永锋, 袁浩. 袁浩谈非创伤性股骨头坏死的现状和研究思路. 中国中医药信息杂志, 2006, 13(4): 87-89.
10.	Lieberman JR, Berry DJ, Mont MA, et al. Osteonecros is of the hip: management in the 21st century. Instr Course Lect, 2003, 52: 337-355.
11.	李子荣. 骨坏死. 北京: 人民卫生出版社, 2012: 183-188.
12.	刘毓, 何伟. 何伟教授保髋治疗股骨头坏死塌陷晚期经验介绍. 新中医, 2010, 42(7): 135-137.
13.	贾晓军, 欧志学, 庞智晖, 等. 何伟教授对于股骨头坏死围塌陷期保髋的创新认识和经验总结. 中医正骨, 2011, 23(12): 956-958.
14.	陈雷雷, 张颖. 何伟教授采用中医药疗法治疗股骨头坏死的经验. 中医正骨, 2015, 27(10): 794-797.
15.	魏秋实, 何伟, 方斌, 等. 中医药治疗股骨头坏死的疗效评价及适应证的初步探索. 中华关节外科杂志(电子版), 2013, 7(3): 294-300.
16.	庞智晖, 欧志学, 魏秋实, 等. 辨塌论治在钽棒治疗早期股骨头坏死中的运用.中国中医骨伤科杂志, 2012, 20(1): 26-29.
17.	方斌, 何伟, 展磊, 等. 不同坏死范围下股骨头坏死区应力分布的有限元分析.中医正骨, 2012, 24(10): 10-15.
18.	陈雷雷. 股骨头坏死 ARCOⅢ期软骨病变研究及证型相关性分析. 广州: 广州中医药大学, 2012.
19.	Ficat RP, Arlet J. Necrosis of the femoral head//Hungefford DS. Ischemia and necrosis of bone. Baltimore: Williams and ilkins, 1980: 53,74.
20.	Lieberman JR. Core decompression for osteonecrosis of the hip. Clin Orthop Relat Res, 2004, (418): 29-33.
21.	Ficat P, Grijalvo P. Long-term results of the forage-biopsy in grade I and II osteonecrosis of the femoral head. Apropos of 133 cases re-examined after an average time of 9 years 6 months. Rev Chir Orthop Reparatrice Appar Mot, 1984, 70(3): 253-255.
22.	Kim SY, KimH, Park, et al. Multiple drilling compared with standard core decompression for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg (Br), 2004, 86(Suppl II): 149.
23.	Al Omran A. Multiple drilling compared with standard core decompression for avascular necrosis of the femoral head in sickle cell disease patients. Arch Orthop Trauma Surg, 2013, 133(5): 609-613.
24.	Pierce TP, Jauregui JJ, Elmallah RK, et al. A current review of core decompression in the treatment of osteonecrosis of the femoral head. Curr Rev Musculoskelet Med, 2015, 8(3): 228-232.
25.	Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg (Br), 1985, 67(1): 3-9.
26.	Hernigou P, Beaujean F, Lambotte JC. Decrease in the mesenchymal stem-cell pool in the proximal femur in corticosteroid-induced osteonecrosis. J Bone Joint Surg (Br), 1999, 81(2): 349-355.
27.	Hernigou P, Beaujean F. Bone marrow activity in the upper femoral extremity in avascular osteonecrosis. Rev Rhum Engl Ed, 1993, 60(1): 610.
28.	Philippe H, Françoise B. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop Relat Res, 2002, (405): 14-23.
29.	Zhao D, Cui D, Wang B, et al. Treatment of early stage osteonecrosis of the femoral head with autologous implantation of bone marrow-derived and cultured mesenchymal stem cells. Bone, 2012, 50(1): 325-330.
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31.	Sugioka Y, Hotokebuchi T, Tsutsui H. Transtrochanteric anterior rotational osteotomy for idiopathic and steroid-induced necrosis of the femoral head. Indications and long-term results. Clin Orthop Relat Res, 1992, (277): 111-120.
32.	张念非, 李子荣, 杨连发, 等. 经股骨粗隆部旋转截骨术治疗股骨头坏死. 中华外科杂志, 2004, 42(24): 1477-1480.
33.	Sonoda K, Yamamoto T, Motomura G, et al. Outcome of transtrochanteric rotational osteotomy for posttraumatic osteonecrosis of the femoral head with a mean follow-up of 12.3 years. Arch Orthop Trauma Surg, 2015, 135(9): 1257-1263.
34.	Chotai P, Shon WY, Suh DH, et al. Femoral head stress fracture: an unknown complication following Sugioka's transtrochanteric rotational osteotomy. Orthopedics, 2011, 34(3): 221.
35.	Hisatome T, Yasunaga Y, Takahashi K, et al. Progressive collapse of transposed necrotic area after transtrochanteric rotational osteotomy for osteonecrosis of the femoral head induces osteoarthritic change. Mid-term results of transtrochanteric rotational osteotomy for osteonecrosis of the femoral head. Arch Orthop Trauma Surg, 2004, 124(2): 77-81.
36.	Hiranuma Y, Atsumi T, Kajiwara T, et al. Evaluation of instability after transtrochanteric anterior rotational osteotomy for nontraumatic osteonecrosis of the femoral head. J Orthop Sci, 2009, 14(5): 535-542.
37.	Kawasaki M, Hasegawa Y, Sakano S, et al. Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Arthroplasty, 2005, 20(5): 574-579.
38.	Park KS, Tumin M, Peni I, et al. Conversion total hip arthroplasty after previous transtrochanteric rotational osteotomy for osteonecrosis of the femoral head. J Arthroplasty, 2014, 29(4): 813-816.
39.	赵德伟. 股骨头缺血性坏死的修复与再造. 3 版. 北京: 人民卫生出版社, 2013: 10.
40.	Poul T, Sandor G, Oleg A, et al. Bone Grafts in Hip Sourgery//Daniel JB, Jay RL. Surgery of the Hip. Holland: Elsevier Medicine, 2013: 189-194.
41.	何伟, 李勇, 张庆文, 等. 蛙式侧位分型在植骨支撑术治疗酒精性股骨头坏死中的意义. 中华关节外科杂志(电子版), 2011, 5(1): 27-33.
42.	Wang BL, Sun W, Shi ZC, et al. Treatment of nontraumatic osteonecrosis of the femoral head using bone impaction grafting through a femoral neck window. Int Orthop, 2010, 34(5): 635-639.
43.	Rosenwasser MP, Garino JP, Kiernan HA, et al. Long-term follow up of thorough debridement and cancellous bone grafting for osteonecrosis of the femoral head. Clin Orthop Relat Res, 1994, (306): 17-27.
44.	Sun W, Li Z, Gao F, et al. Recombinant human bone morphogenetic protein-2 in debridement and impacted bone graft for the treatment of femoral head osteonecrosis. PLoS One, 2014, 9(6): e100424.
45.	Zhou G, Zhang Y, Zeng L, et al. Should thorough Debridement be used in Fibular Allograft with impaction bone grafting to treat Femoral Head Necrosis: a biomechanical evaluation. BMC Musculoskelet Disord, 2015, 16: 140.
46.	何伟. 整体观念在股骨头坏死诊断与治疗中的应用. 江苏中医药, 2008, 40(5): 1-2.
47.	何伟, 李勇, 张庆文, 等. 自体或同种异体腓骨联合打压植骨治疗股骨头坏死的初步研究. 中国修复重建外科杂志, 2009, 23(5): 530-533.
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1. 欧志学, 贾晓军, 庞智晖, 等. 何伟教授治疗股骨头坏死塌陷前期经验介绍. 新中医, 2011, 43(5): 155-156.
2. Mont MA, Cherian JJ, Sierra RJ, et al. Nontraumatic Osteonecrosis of the Femoral Head: Where Do We Stand Today? A Ten-Year Update. J Bone Joint Surg (Am), 2015, 97(19): 1604-1627.
3. Nam KW, Kim YL, Yoo JJ, et al. Fate of untreated asymptomatic osteonecrosis of the femoral head. J Bone Joint Surg (Am), 2008, 90(3): 477-484.
4. Zhang NF, Li ZR, Wei HY, et al. Steroid-induced osteonecrosis: the number of lesions is related to the dosage. J Bone Joint Surg (Br), 2008, 90(9): 1239-1243.
5. Nagasawa K, Tada Y, Koarada S, et al. Very early development of steroid-associated osteonecrosis of femoral head in systemic lupus erythematosus: prospective study by MRI. Lupus, 2005, 14(5): 385-390.
6. 何伟. 如何把握股骨头坏死患者的保髋治疗时机. 中国骨与关节杂志, 2016, 5(2): 82-86.
7. Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association. Guideline for Diagnostic and Treatment of Osteonecrosis of the Femoral Head. Orthop Surg, 2015, 7(3): 200-207.
8. Etienne G, Mont MA, Ragland PS. The diagnosis and treatment of nontraumatic osteonecrosis of the femoral head. Instr Course Lect, 2004, 53: 67-85.
9. 崔永锋, 袁浩. 袁浩谈非创伤性股骨头坏死的现状和研究思路. 中国中医药信息杂志, 2006, 13(4): 87-89.
10. Lieberman JR, Berry DJ, Mont MA, et al. Osteonecros is of the hip: management in the 21st century. Instr Course Lect, 2003, 52: 337-355.
11. 李子荣. 骨坏死. 北京: 人民卫生出版社, 2012: 183-188.
12. 刘毓, 何伟. 何伟教授保髋治疗股骨头坏死塌陷晚期经验介绍. 新中医, 2010, 42(7): 135-137.
13. 贾晓军, 欧志学, 庞智晖, 等. 何伟教授对于股骨头坏死围塌陷期保髋的创新认识和经验总结. 中医正骨, 2011, 23(12): 956-958.
14. 陈雷雷, 张颖. 何伟教授采用中医药疗法治疗股骨头坏死的经验. 中医正骨, 2015, 27(10): 794-797.
15. 魏秋实, 何伟, 方斌, 等. 中医药治疗股骨头坏死的疗效评价及适应证的初步探索. 中华关节外科杂志(电子版), 2013, 7(3): 294-300.
16. 庞智晖, 欧志学, 魏秋实, 等. 辨塌论治在钽棒治疗早期股骨头坏死中的运用.中国中医骨伤科杂志, 2012, 20(1): 26-29.
17. 方斌, 何伟, 展磊, 等. 不同坏死范围下股骨头坏死区应力分布的有限元分析.中医正骨, 2012, 24(10): 10-15.
18. 陈雷雷. 股骨头坏死 ARCOⅢ期软骨病变研究及证型相关性分析. 广州: 广州中医药大学, 2012.
19. Ficat RP, Arlet J. Necrosis of the femoral head//Hungefford DS. Ischemia and necrosis of bone. Baltimore: Williams and ilkins, 1980: 53,74.
20. Lieberman JR. Core decompression for osteonecrosis of the hip. Clin Orthop Relat Res, 2004, (418): 29-33.
21. Ficat P, Grijalvo P. Long-term results of the forage-biopsy in grade I and II osteonecrosis of the femoral head. Apropos of 133 cases re-examined after an average time of 9 years 6 months. Rev Chir Orthop Reparatrice Appar Mot, 1984, 70(3): 253-255.
22. Kim SY, KimH, Park, et al. Multiple drilling compared with standard core decompression for the treatment of osteonecrosis of the femoral head. J Bone Joint Surg (Br), 2004, 86(Suppl II): 149.
23. Al Omran A. Multiple drilling compared with standard core decompression for avascular necrosis of the femoral head in sickle cell disease patients. Arch Orthop Trauma Surg, 2013, 133(5): 609-613.
24. Pierce TP, Jauregui JJ, Elmallah RK, et al. A current review of core decompression in the treatment of osteonecrosis of the femoral head. Curr Rev Musculoskelet Med, 2015, 8(3): 228-232.
25. Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg (Br), 1985, 67(1): 3-9.
26. Hernigou P, Beaujean F, Lambotte JC. Decrease in the mesenchymal stem-cell pool in the proximal femur in corticosteroid-induced osteonecrosis. J Bone Joint Surg (Br), 1999, 81(2): 349-355.
27. Hernigou P, Beaujean F. Bone marrow activity in the upper femoral extremity in avascular osteonecrosis. Rev Rhum Engl Ed, 1993, 60(1): 610.
28. Philippe H, Françoise B. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop Relat Res, 2002, (405): 14-23.
29. Zhao D, Cui D, Wang B, et al. Treatment of early stage osteonecrosis of the femoral head with autologous implantation of bone marrow-derived and cultured mesenchymal stem cells. Bone, 2012, 50(1): 325-330.
30. 孙伟, 李子荣, 王佰亮, 等. 髓芯减压加自体骨髓干细胞移植治疗股骨头坏死的早期随访结果. 中国组织工程研究与临床康复, 2008, 12(12): 2231-2234.
31. Sugioka Y, Hotokebuchi T, Tsutsui H. Transtrochanteric anterior rotational osteotomy for idiopathic and steroid-induced necrosis of the femoral head. Indications and long-term results. Clin Orthop Relat Res, 1992, (277): 111-120.
32. 张念非, 李子荣, 杨连发, 等. 经股骨粗隆部旋转截骨术治疗股骨头坏死. 中华外科杂志, 2004, 42(24): 1477-1480.
33. Sonoda K, Yamamoto T, Motomura G, et al. Outcome of transtrochanteric rotational osteotomy for posttraumatic osteonecrosis of the femoral head with a mean follow-up of 12.3 years. Arch Orthop Trauma Surg, 2015, 135(9): 1257-1263.
34. Chotai P, Shon WY, Suh DH, et al. Femoral head stress fracture: an unknown complication following Sugioka's transtrochanteric rotational osteotomy. Orthopedics, 2011, 34(3): 221.
35. Hisatome T, Yasunaga Y, Takahashi K, et al. Progressive collapse of transposed necrotic area after transtrochanteric rotational osteotomy for osteonecrosis of the femoral head induces osteoarthritic change. Mid-term results of transtrochanteric rotational osteotomy for osteonecrosis of the femoral head. Arch Orthop Trauma Surg, 2004, 124(2): 77-81.
36. Hiranuma Y, Atsumi T, Kajiwara T, et al. Evaluation of instability after transtrochanteric anterior rotational osteotomy for nontraumatic osteonecrosis of the femoral head. J Orthop Sci, 2009, 14(5): 535-542.
37. Kawasaki M, Hasegawa Y, Sakano S, et al. Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Arthroplasty, 2005, 20(5): 574-579.
38. Park KS, Tumin M, Peni I, et al. Conversion total hip arthroplasty after previous transtrochanteric rotational osteotomy for osteonecrosis of the femoral head. J Arthroplasty, 2014, 29(4): 813-816.
39. 赵德伟. 股骨头缺血性坏死的修复与再造. 3 版. 北京: 人民卫生出版社, 2013: 10.
40. Poul T, Sandor G, Oleg A, et al. Bone Grafts in Hip Sourgery//Daniel JB, Jay RL. Surgery of the Hip. Holland: Elsevier Medicine, 2013: 189-194.
41. 何伟, 李勇, 张庆文, 等. 蛙式侧位分型在植骨支撑术治疗酒精性股骨头坏死中的意义. 中华关节外科杂志(电子版), 2011, 5(1): 27-33.
42. Wang BL, Sun W, Shi ZC, et al. Treatment of nontraumatic osteonecrosis of the femoral head using bone impaction grafting through a femoral neck window. Int Orthop, 2010, 34(5): 635-639.
43. Rosenwasser MP, Garino JP, Kiernan HA, et al. Long-term follow up of thorough debridement and cancellous bone grafting for osteonecrosis of the femoral head. Clin Orthop Relat Res, 1994, (306): 17-27.
44. Sun W, Li Z, Gao F, et al. Recombinant human bone morphogenetic protein-2 in debridement and impacted bone graft for the treatment of femoral head osteonecrosis. PLoS One, 2014, 9(6): e100424.
45. Zhou G, Zhang Y, Zeng L, et al. Should thorough Debridement be used in Fibular Allograft with impaction bone grafting to treat Femoral Head Necrosis: a biomechanical evaluation. BMC Musculoskelet Disord, 2015, 16: 140.
46. 何伟. 整体观念在股骨头坏死诊断与治疗中的应用. 江苏中医药, 2008, 40(5): 1-2.
47. 何伟, 李勇, 张庆文, 等. 自体或同种异体腓骨联合打压植骨治疗股骨头坏死的初步研究. 中国修复重建外科杂志, 2009, 23(5): 530-533.
48. Ganz R, Gill TJ, Gautier E, et al. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg (Br), 2001, 83(8): 1119-1124.
49. Cohen R. A porous tantalum trabecular metal: basic science. Am J Orthop (Belle Mead NJ), 2002, 31(4): 216-217.
50. Pedersen DR, Brown TD, Poggie RA. Finite element characterization of a porous tantalum material for treatment of avascular necrosis. Trans Orthop Res Soc, 1997, 22: 598.
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Chinese Journal of Reparative and Reconstructive Surgery

A summary of hip-preservation surgery based on peri-collapse stage of osteonecrosis of femoral head

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