The first experience of arthroscopy in the case of aseptic necrosis of the femoral head

Authors

  • Maxim Golovakha Zaporizhzhia State Medical University. Ukraine, Ukraine https://orcid.org/0000-0003-2835-9333
  • Vadym Kirichenko «Garvis» Clinic, Dnipro. Ukraine, Ukraine
  • Olexandra Grytsenko «Garvis» Clinic, Dnipro. Ukraine, Ukraine
  • Rostyslav Tytarchuk «Garvis» Clinic, Dnipro. Ukraine, Ukraine
  • Stanislav Bondarenko «Motor Sich» Clinic, Zaporizhzhia. Ukraine, Ukraine

DOI:

https://doi.org/10.15674/0030-59872021239-44

Keywords:

Hip joint, aseptic necrosis, arthroscopy

Abstract

Observation of patients with avascular necrosis of the femoral head formed a hypothesis about inability to eliminate the hip contracture by tunneling the femoral head on the background of drug therapy and therapeutic exercises, which causes an unsatisfactory outcomes. Therefore, the was idea to use arthroscopy for performing capsulotomy, synovectomy and removal of free cartilage and bone fragments. Objective. To evaluate efficiency of arthroscopy in patients with avascular necrosis of the femoral head. Methods. In the period from 2010 to 2018, 60 patients were observed. With the I–II stages, absence of inflammatory processes in the joint, body mass index less than 35. In the comparison group (28 patients) we made  only tunneling of the femoral head, in the study group (32) at first  we performed arthroscopy of the hip joint, capsulotomy, synovectomy, removal of cartilage fragments, and only then — tunneling. We analyzed the proportion of hip joint replacement that was performed in the long term follow up and the intensity of pain by visual analog scale. Results. During arthroscopy we often revealed the joint cartilage lesions — 30 %, articular labrum lesions — 5 %, synovitis — 100 %, CAM impingement — 90 %. In the study group in the first 2 weeks after surgery, the pain was severe more than in the comparison group. Then the pain rate became the same in both groups. In the control group in the period from 3 to 5 years after tunneling of the femoral head, arthroplasty was performed in 11 patients (39.3 %), in the study group for 2 to 3 years after surgery — 8 (25.0 %). Conclusions. Analysis of long-term results of tunneling of the femoral head with arthroscopy of the hip joint in patients with avascular necrosis of the femoral head showed improvement in hip function, no disease progression in 60–75 % patients in 2–3 years after surgery.

Author Biographies

Maxim Golovakha, Zaporizhzhia State Medical University. Ukraine

MD, Prof. in Traumatology and Orthopaedics

Vadym Kirichenko, «Garvis» Clinic, Dnipro. Ukraine

MD, PhD in Traumatology and Orthopaedics

Olexandra Grytsenko, «Garvis» Clinic, Dnipro. Ukraine

MD

Rostyslav Tytarchuk, «Garvis» Clinic, Dnipro. Ukraine

MD

Stanislav Bondarenko, «Motor Sich» Clinic, Zaporizhzhia. Ukraine

MD

References

  1. Filipenko, V. A., Olinichenko, G. D., Miteleva, Z. M., & Poletaeva, N. Yu. (2013). The results of surgical treatment of aseptic necrosis of the femoral head in the early stages. Orthopedics, Traumatology and Prosthetics, 1, 5–9. https://doi.org/10.15674/0030-5987201315-9. [in Ukrainian]
  2. Hsu, H., & Nallamothu, S. V. (2020). Hip Osteonecrosis. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499954
  3. Lieberman, J. R., Berry, D. J., Mont, M. A., Aaron, R. K., Callaghan, J. J., Rayadhyaksha, A., & Urbaniak, J. R. (2002). Osteonecrosis of the hip. The Journal of Bone and Joint Surgery-American Volume, 84(5), 834-853. https://doi.org/10.2106/00004623-200205000-00023
  4. Mont, M. A., Marulanda, G. A., Jones, L. C., Saleh, K. J., Gordon, N., Hungerford, D. S., & Steinberg, M. E. (2006). Systematic analysis of classification systems for osteonecrosis of the femoral head. The Journal of Bone and Joint Surgery-American Volume, 88, 16-26. https://doi.org/10.2106/00004623-200611001-00004
  5. Kachanov, D. A., Usov, S. A., & Vostrilov, I. M. (2019). Possibilities of treatment of aseptic necrosis of the femoral head. International research journal, 12(90), 201–203. https://doi.org/10.23670/IRJ.2019.90.12.042. [in Russian]
  6. Martín-Hernández, Bejarano-Lasunción, Martínez-Aznar, Rodríguez-Nogué, Hernández-Fernández, & Pinilla-Gracia. (2020). Epidemiología, resultados clínicos Y tasa de éxito en cirugía preservadora de cadera en la necrosis avascular de Cabeza femoral. Acta Ortopédica Mexicana, 34(1), 16-21. https://doi.org/10.35366/94618
  7. Hanke, M. S., Schmaranzer, F., Steppacher, S. D., Lerch, T. D., & Siebenrock, K. A. (2020). Hip preservation. EFORT Open Reviews, 5(10), 630-640. https://doi.org/10.1302/2058-5241.5.190074
  8. Martinot, P., Dartus, J., Leclerc, J. T., Putman, S., Girard, J., & Migaud, H. (2020). Hip survival after plain core decompression alone versus bone morphogenetic protein and/or bone marrow reinjection with core decompression for avascular osteonecrosis of the femoral head: A retrospective case control study in ninety two patients. International Orthopaedics, 44(11), 2275-2282. https://doi.org/10.1007/s00264-020-04692-w
  9. Martinot, P., Dartus, J., Justo, A., Riouach, H., Cremer, P., Flouzat-Lachaniette, C., ... & Chiron, P. (2020). Does augmented core decompression decrease the rate of collapse and improve survival of femoral head avascular necrosis? case-control study comparing 184 augmented core decompressions to 79 standard core decompressions with a minimum 2 years’ follow-up. Orthopaedics & Traumatology: Surgery & Research, 106(8), 1561-1568. https://doi.org/10.1016/j.otsr.2020.03.040
  10. McCarthy, J., Puri, L., Barsoum, W., Lee, J., Laker, M., & Cooke, P. (2003). Articular cartilage changes in avascular necrosis: An Arthroscopic evaluation. Clinical Orthopaedics and Related Research, 406, 64-70. https://doi.org/10.1097/00003086-200301000-00011
  11. Rocchi, M., Del Piccolo, N., Mazzotta, A., Giavaresi, G., Fini, M., Facchini, F., Stagni, C., & Dallari, D. (2020). Core decompression with bone chips allograft in combination with fibrin platelet-rich plasma and concentrated autologous mesenchymal stromal cells, isolated from bone marrow: Results for the treatment of avascular necrosis of the femoral head after 2 years minimum follow-up. HIP International, 30(2 suppl), 3-12. https://doi.org/10.1177/1120700020964996
  12. Sekiya, J. K., Ruch, D. S., & Hunter, D. M. (2000). Hip arthroscopy in staging avascular necrosis of the femoral head. Journal of the Southern Orthopaedic Association, 9(4), 254–261.

Downloads

How to Cite

Golovakha, M. ., Kirichenko, V., Grytsenko, O. ., Tytarchuk, R. ., & Bondarenko, S. (2023). The first experience of arthroscopy in the case of aseptic necrosis of the femoral head. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (2), 39–44. https://doi.org/10.15674/0030-59872021239-44

Issue

No. 2 (2021)

Section

ORIGINAL ARTICLES

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).