Journal of Hip Preservation Surgery最新文献

{"title":"Osteotomy angle to the femoral neck axis affects the postoperative intact ratio in curved varus osteotomy for osteonecrosis of the femoral head.","authors":"Tatsuhiko Kutsuna, Tomofumi Kinoshita, Shinichiro Sakai, Kohei Kono, Hiroshi Kiyomatsu, Kunihiko Watamori, Kazunori Hino, Naohiko Mashima, Masaki Takao","doi":"10.1093/jhps/hnaf016","DOIUrl":"10.1093/jhps/hnaf016","url":null,"abstract":"<p><p>Curved varus osteotomy (CVO) is a surgical option to preserve a hip joint affected by osteonecrosis of the femoral head (ONFH). Femoral anteversion varies among patients; however, the osteotomy design on the axial plane in CVO has not been well investigated. This study evaluated the variation in the osteotomy angle on the axial plane in a CVO and its effect on the postoperative intact ratio, which determines the postoperative outcome. This study included 10 patients with Type C1 ONFH who underwent CVO according to the Japanese Investigation Committee classification. The osteotomy angles relative to the posterior condylar and femoral neck axes on the axial plane were measured on postoperative computed tomography images. The progression of collapse and osteoarthritic change were reviewed on serial radiographs. The mean osteotomy angles to the posterior condylar axis and the femoral neck axis were 0.2° and 15.3°, respectively. The mean postoperative intact ratio was 45.6% (range: 28.0-62.8%). The osteotomy angle to the femoral neck axis was significantly and negatively correlated with the postoperative intact ratio (<i>ρ</i> = -0.782, <i>P</i> = .008). In three cases, the osteotomy line was directed >25° anteromedial to the femoral neck axis, and the postoperative intact ratio was less than the target (34%); one showed progression of the collapse of the femoral head, and another an osteoarthritic change. We observed wide variations in the osteotomy angle on the axial plane during manually performed CVO. The osteotomy angle to the femoral neck axis on the axial plane affected the postoperative intact ratio.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 3","pages":"175-180"},"PeriodicalIF":1.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain relieving effects of Botox injection in the hip joint following a periacetabular osteotomy.","authors":"Niels Bang, Bjarne Mygind-Klavsen, Bent Lund, Casper Foldager, Stig Storgaard Jacobsen","doi":"10.1093/jhps/hnaf019","DOIUrl":"10.1093/jhps/hnaf019","url":null,"abstract":"<p><p>Patients with symptomatic hip dysplasia may undergo periacetabular osteotomy (PAO) and 10% of these patients have pain >6 months after the operation. An intra-articular lidocaine injection is used to determine if the pain comes from labral pathology in the hip joint or structures around the hip. To allow the patient a longer period of time to test the hip, we wanted to test if an intra-articular injection of Botox combined with local anaesthetic could reduce pain and allow the patient to test the hip. Eleven patients who received a PAO and suffered from persistent pain at least 6 months postoperative had an intra-articular joint injection with 100IE Botox, 3 ml NaCl water and 3 ml lidocaine. Hip pain on the day of injection and after 6 weeks was evaluated using the Visual Analog Scale score, International Hip Outcome Tool (iHOT-12), and Hip and Groin Outcome Score (HAGOS). Botox in the hip joint reduced the pain level and the iHOT-12 score, with a statistically significant improvement 6 weeks after injection. Hip joint injection of a controlled dosage of 100 IU diluted in 3 ml NaCl solution mixed with lidocaine had no side effects in this study with a limited group of patients. Botox has a promising pain-reducing effect on the hip joint in the majority of patients comparable with findings in knee and shoulder joints. Hip joint injection of a controlled dosage of 100 IU, 3 ml NaCl solution mixed with lidocaine had no side effects in this study with a limited group of patients.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 3","pages":"195-201"},"PeriodicalIF":1.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic-assisted core decompression for avascular necrosis of the femoral head demonstrates favorable clinical outcomes: a systematic review.","authors":"Muzammil Akhta, Daniel Razick, Noorhan Amani, Sonia Aamer, Jimmy Wen, Trevor Shelton, Dean Wang","doi":"10.1093/jhps/hnaf018","DOIUrl":"10.1093/jhps/hnaf018","url":null,"abstract":"<p><p>This systematic review aims to evaluate clinical outcomes for arthroscopic-assisted core decompression (AACD) for avascular necrosis (AVN) of the femoral head. A literature search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed in PubMed, Embase, and Scopus. Nine studies were included, five comparing AACD with isolated core decompression (CD) and four evaluating outcomes of only AACD. A total of 358 patients (462 hips, 71.8% male) underwent AACD. In the five comparative studies, the AACD and isolated CD groups had 97.6% (72.2-100.0%) and 98.5% (81.0-100.0%) of hips with precollapse AVN, respectively. The modified Harris hip score, reported in five comparative studies, was significantly higher in the AACD group in four studies and not significantly different in one study. The visual analog scale pain score, reported in two comparative studies, was significantly lower in the AACD group in one study and not significantly different in the other study. The collapse rate ranged from 2.9% to 14.0% at a mean follow-up of 37.9 months in the AACD group and from 14.6% to 28.6% at a mean follow-up of 34.7 months in the isolated CD group, with all five comparative studies reporting significantly higher collapse rates in the isolated CD group. In the four AACD only studies, 42.9-100.0% of hips had precollapse AVN with the collapse rate ranging from 23.2% to 45.5% at a mean follow-up of 39.2 months. Patients undergoing AACD for treatment of AVN of the femoral head demonstrate excellent patient-reported outcomes and low rate of collapse and complications, with a possibility of superior outcomes compared to isolated CD.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 3","pages":"186-194"},"PeriodicalIF":1.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral versus acetabular osteotomy for treating combined version deformities leading to femoroacetabular impingement: a case-control matched study.","authors":"Kartik Logishetty, Paul Haggis, Saif Salih, George Grammatopoulos, Tom Pollard, Johan D Witt, Antonio J Andrade","doi":"10.1093/jhps/hnaf013","DOIUrl":"10.1093/jhps/hnaf013","url":null,"abstract":"<p><p>The aim of this study was to compare outcomes between anteverting proximal femoral osteotomy (APFO) and anteverting periacetabular osteotomy (APAO) for femoroacetabular impingement syndrome (FAIS) due to combined acetabular retroversion (ARV) and femoral retrotorsion (FRT). We also compared these outcomes with hip arthroscopy (HA) for FAIS without ARV or FRT. Twelve patients with ARV and FRT underwent either APAO (six) or APFO (six) at two centres. A control group of 24 patients underwent HA for FAIS without version abnormality. Outcome measures included various hip scores, time to radiological bony union, complications, and conversion to hip arthroplasty. At the 2-year follow-up, no AFPO or APAO hips required arthroplasty. Patient-reported outcome scores showed no significant difference between the APAO and APFO groups: Non-Arthritic Hips Scores (NAHS) (APAO: median 72, range 52-78; APFO: 76, 52-80, <i>P</i> = .76), International Hip Outcome Tool 12 (iHOT-12) (APAO: 64, 48-70 vs. APFO: 55, 46-72, <i>P</i> = .57), EuroQol 5 Dimension Visual Analogue Scale (APAO: 72, 57-78 vs. APFO: 75, 49-80 <i>P</i> = .78), and University of California Los Angeles Score (APAO: 7, 4-8 vs. APFO: 6, 4-9 <i>P</i> = .43). APAO patients achieved radiological union faster (10.2 weeks: 6.6-19.3 vs. 19.2 weeks: 12-23, <i>P</i> = .05). Aside from metalwork removal, one AFPO patient required revision intramedullary nail to induce union. Compared to AFPO or APAO, HA patients (NAHS: 86.7, 72.1-94.1; iHOT-12: 73.1, 63.2-88.1) had better outcome scores (<i>P</i> < .05). Both APFO and APAO can achieve good outcomes and short-term survivorship for combined ARV and FRT, although function may be inferior to HA in patients without rotational abnormalities.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 3","pages":"164-168"},"PeriodicalIF":1.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of intra-articular corticosteroid injection in predicting pain relief following periacetabular osteotomy.","authors":"Carter E Hall, David P VanEenenaam, Christopher J DeFrancesco, Naomi Brown, Hannah R Baron, Wudbhav N Sankar","doi":"10.1093/jhps/hnaf014","DOIUrl":"10.1093/jhps/hnaf014","url":null,"abstract":"<p><p>Determining which patients with acetabular dysplasia will benefit most from periacetabular osteotomy (PAO) can be challenging. Intra-articular corticosteroid injection (CSI) is often used for therapeutic and diagnostic purposes in various hip pathologies. This study aims to assess the relationship between self-reported preoperative CSI pain relief and postoperative pain relief after PAO. The case log of a single hip-preservation surgeon was queried from 2013 onward for patients who underwent PAO with preoperative intra-articular CSI. Patients were asked, 'overall, what percent improved are your symptoms from 0-100%?' following preoperative CSI and again at each postoperative visit. A successful postoperative pain outcome was defined as pain relief ≥75% compared to preoperative symptoms at the approximate 6 month postoperative visit. A total of 76 hips met inclusion criteria. Average self-reported relief from preoperative intra-articular CSI was 70 ± 35%. Mean postoperative pain relief was 88 ± 18%. Analysis showed a positive but weak correlation between preoperative CSI response and postoperative relief (0.278, <i>P</i> = .016). Receiver operator characteristic curve analysis found CSI pain relief ≥60% to be the optimal threshold for predicting a successful postoperative pain outcome. Positive predictive value remained high and negative predictive value (NPV) remained low over a range of CSI relief thresholds. Most patients had significant pain relief following PAO, with only 10 patients failing to achieve at least 75% improvement. As a result, the NPV associated with any CSI pain relief threshold remained low. As our patients generally experienced significant postoperative pain relief regardless of preoperative CSI response, further work is warranted to identify those less likely to benefit from surgery.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 3","pages":"169-174"},"PeriodicalIF":1.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of platelet-rich plasma in pain management of osteoarthritis with developmental dysplasia of the hip: a double-blind, randomized controlled trial.","authors":"Yusuke Okanoue, Masahiko Ikeuchi, Junpei Dan, Yuki Teranishi","doi":"10.1093/jhps/hnaf008","DOIUrl":"10.1093/jhps/hnaf008","url":null,"abstract":"<p><p>This study evaluates the efficacy of administering platelet-rich plasma (PRP) compared to hyaluronic acid (HA) for pain management hip osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH). It highlights PRP treatment as a slightly more effective or equivalent treatment for reducing hip pain in such cases. From 2019 to 2021, a double-blind, randomized controlled trial was conducted with 42 patients who consented to participate. They were divided into two groups: one receiving intra-articular PRP injections and the other HA injections. The primary focus of the study was pain relief, measured using the pain-Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-pain scores over a 24-week period. Functionality was assessed as a secondary outcome. The results showed significant pain reduction in both PRP and HA groups compared to their baseline pain levels. Notably, the PRP treatment group exhibited a marginally higher improvement in pain-VAS scores (38.5) than the HA group (18.7; <i>P</i> = .041). However, the difference in WOMAC-pain scores between the groups was not statistically significant (4.3 for PRP vs. 2.9 for HA; <i>P</i> = .245). The Kellgren-Lawrence grade was the only factor significantly associated with the improvement in pain-VAS scores within the PRP group. The study finds that PRP treatment is at least as effective as HA treatment in reducing hip pain for OA secondary to DDH. Treatment with PRP showed notably better pain-VAS scores compared to HA, highlighting its potential. Therefore, intra-articular PRP injections are a viable alternative to HA for effectively reducing pain in OA secondary to DDH.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 4","pages":"230-236"},"PeriodicalIF":1.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for insufficient hip distraction for safe central compartment access during hip arthroscopy: retrospective analysis of 677 cases.","authors":"Ching-Chien Chiang, Hao-Che Tang, Cheng-Pang Yang, Huan Sheu, Chieh-An Chuang, Yi-Sheng Chan","doi":"10.1093/jhps/hnaf009","DOIUrl":"10.1093/jhps/hnaf009","url":null,"abstract":"<p><p>Sufficient hip distraction is crucial for the assessment of the central compartment in hip arthroscopic surgery. The aim of this study was to identify the risk factors linked to insufficient hip distraction during hip arthroscopic surgery. We hypothesized that the presence of pincer- or mixed-type femoroacetabular impingement (FAI) could hinder effective hip distraction during the procedure. Inclusion criteria included indication for hip arthroscopy, and persistent symptoms that have not responded to extensive conservative treatment, such as activity adjustments and physical therapy over a period of 6-12 weeks. The enrollment period spanned from January 2003 to May 2021. Data on age, sex, diagnosis of FAI, body mass index, body height, body weight, lateral center-edge angle (LCEA), hip joint space, Tönnis grading, and Beighton score were collected. Among the cases, 34 had insufficient hip distraction while 643 did not. Crude odds ratio analysis revealed that male gender, body height, increased LCEA, the presence of pincer- or mixed-type FAI, and a lower Beighton score were associated with a higher risk of insufficient distraction. Further analyses confirmed that only FAI, sex, and Beighton score remained significant predictors of risk. Adjusted odds ratios indicated a strong association with pincer- or mixed-type FAI. The presence of pincer- or mixed-type FAI is identified as a risk factor for insufficient hip distraction during hip arthroscopic surgery. In high-risk patients, adopting a peripheral compartment approach initially and avoiding hip traction can help prevent traction-related complications.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 4","pages":"223-229"},"PeriodicalIF":1.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"iHOT-12 item analysis: correlations between individual items and overall score within and across time points.","authors":"Matthew Yuro, Robroy Martin, Andrew B Wolff, Shane Nho, Thomas Wuerz, Geoff Van Thiel, John Christoforetti, John P Salvo, Dean Matsuda, Dominic S Carreira","doi":"10.1093/jhps/hnaf004","DOIUrl":"10.1093/jhps/hnaf004","url":null,"abstract":"<p><p>The main aim of this study was to analyze correlations between individual international hip outcome tool 12 (iHOT-12) items and overall iHOT-12 score within and across timepoints. A retrospective multicenter hip arthroscopy registry was queried for patients from January 2014 to October 2023 with completed iHOT-12 reports. Pearson coefficient analysis was used to identify correlations between individual iHOT-12 items and overall iHOT-12 score at each timepoint and between preoperative individual iHOT-12 items and postoperative overall iHOT-12 scores. Validity, reliability, and responsiveness of the iHOT-12 were analyzed at each timepoint. Within timepoints, correlations ranged in strength from fair (preoperative maintain fitness level, <i>r</i> = 0.52, <i>P</i> < .00001) to excellent (5-year hip pain after activity, <i>r</i> = 0.93, <i>P</i> < .00001). Correlations increased in strength over time. Across timepoints, correlations ranged in strength from no correlation (2-year maintain fitness level, <i>r</i> = -0.001, <i>P</i> = 0.94) to poor (6-month pushing or lifting heavy objects, <i>r</i> = 0.31, <i>P</i> < .00001). Correlations decreased in strength over time. No ceiling or floor effects were exhibited. The Cronbach alpha for the baseline, 6-month, 1-year, 2-year, and 5-year timepoints were 0.87, 0.96, 0.95, 0.96, and 0.97, respectively. Cohen's <i>d</i> values at 6 months, 1 year, 2 years, and 5 years were 1.19, 1.43, 1.71, and 1.58, respectively. Within timepoints, hip pain after activity had the strongest correlations to overall iHOT-12 score. Across timepoints, correlations between preoperative individual iHOT-12 items and postoperative overall iHOT-12 score were poor and weakened over time, suggesting similar long-term postoperative iHOT-12 scores among both high- and low-scoring preoperative patients. The iHOT-12 demonstrated good validity, reliability, and responsiveness at all timepoints.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"118-124"},"PeriodicalIF":1.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive solutions for ischiofemoral impingement: case analysis and evolving surgical strategies.","authors":"Inês Palma, Afonso Nave, Tiago Torres, Ana Luísa Neto, José Campos Martins, António Seco","doi":"10.1093/jhps/hnaf010","DOIUrl":"10.1093/jhps/hnaf010","url":null,"abstract":"<p><p>Variations in the femoral version are increasingly recognized as a cause of coxalgia due to impingement or instability. The true prevalence of these variations remains unknown. The authors report a case of bilateral ischiofemoral impingement (IFI) caused by excessive femoral anteversion treated with a subtrochanteric femoral derotational osteotomy and long intramedullary nailing. We report the case of a 22-year-old female patient with deep left hip pain, consistent with IFI, refractory to conservative treatment. Imaging revealed an ischiofemoral space (IFS) of 16 mm and a femoral anteversion of 34°. A subtrochanteric femoral derotational osteotomy stabilized with a long intramedullary nail was performed. At 18 months, the same surgical procedure was performed due to similar symptoms on the right side, with an IFS of 14 mm and femoral anteversion of 35°. Joint mobility was restored bilaterally, and the symptoms were resolved. Lesser trochanter resection has been reported as a surgical option for IFI in small case series. While conventional subtrochanteric femoral derotational osteotomy with plate fixation shows good functional outcomes, pseudarthrosis remains a concern. The authors' minimally invasive technique using the backstroke technique for osteotomy site compression helps prevent this complication while preserving the iliopsoas insertion. In this case study, a subtrochanteric femoral derotational osteotomy effectively treated bilateral IFI associated with increased femoral anteversion. The patient achieved excellent clinical outcomes with complete symptom resolution following successful consolidation of both osteotomies, though subsequent implant removal was performed to facilitate potential future surgeries.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"144-149"},"PeriodicalIF":1.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of teriparatide and factors for the collapse of femoral head following femoral curved varus osteotomy.","authors":"Shunichi Yokota, Tomohiro Shimizu, Hotaka Ishizu, Yutaro Sugawara, Yusuke Ohashi, Tsuyoshi Asano, Daisuke Takahashi, Norimasa Iwasaki","doi":"10.1093/jhps/hnaf005","DOIUrl":"10.1093/jhps/hnaf005","url":null,"abstract":"<p><p>Osteonecrosis of the femoral head (ONFH) often leads to femoral head collapse, which makes joint preservation challenging. Although curved varus osteotomy (CVO) is an effective surgical method for joint preservation in young ONFH patients, there are some cases where it cannot prevent femoral head collapse. This research aims to evaluate the usefulness of teriparatide (TPD) in bone healing and preventing femoral head collapse in CVO-treated ONFH patients. This retrospective study included 48 patients (56 hips) diagnosed with ONFH, categorized into three groups: glucocorticoid-associated ONFH with TPD treatment (GCs + TPD), glucocorticoid-associated ONFH (GCs), and alcohol- associated ONFH (Alc). No significant differences were found in terms of surgical details, stage, conversion to total hip arthroplasty (THA), and clinical scores. The GCs + TPD group showed a shorter bone union duration, reduced femoral head collapse, and a lower incidence of advanced collapse than the other groups. Lower BMI and TPD use were associated with a shorter duration of bone union. TPD and union duration were identified as factors contributing to the advanced collapse. In conclusion, TPD administration accelerates bone union at the osteotomy site and mitigates femoral head collapse after joint-preserving osteotomy. In addition, combining TPD with CVO may be a promising strategy for younger patients.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"12 2","pages":"125-133"},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}