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Functional outcomes of bilateral hip necrosis: total hip arthroplasty versus extracorporeal shockwave

  • Orthopaedic Outcome Assessment
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This study compared the functional outcomes of total hip (THA) in one and shockwave (ESWT) in the other in 17 patients with bilateral hip necrosis.

Method

In THA side, only one type of prosthesis was used and all components were press fixed. In ESWT side, each hip received 6,000 impulses of shockwave at 28 kv.

Results

The evaluations included pain score and Harris hip score, radiographs and MR images. The magnitudes of improvement in pain and function favored the ESWT side. Thirteen patients rated ESWT better than THA; four patients reported comparable results between THA and ESWT, and none graded THA better than ESWT. Better functional outcomes were observed after ESWT for early hip necrosis than THA for late cases in patients with bilateral hip disease.

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References

  1. Bradway JK, Morrey BF (1993) The natural history of the silent hip in bilateral atraumatic osteonecrosis. J Arthroplast 8:383–387

    Article  CAS  Google Scholar 

  2. Cabanela ME (1990) Bipolar versus total hip arthroplasty for avascular necrosis of the femoral head: a comparison. Clin Orthop 261:59–62

    PubMed  Google Scholar 

  3. Celebi L, Muratli HH, Akahin E, Yamurlu MF, Yuksel HY, Bicimolu A (2006) Cementless total hip arthroplasty in patients with avascular necrosis of the femoral head. Acta Orthop Traumatol Turc 40(2):105–110

    PubMed  Google Scholar 

  4. D’Antonio JA, Capello WN, Manley MT, Feinberg J (1997) Hydroxyapatite coated implants: total hip arthroplasty in the young patients and patients with avascular necrosis. Clin Orthop 344:124–138

    PubMed  Google Scholar 

  5. Dudkiewicz I, Covo A, Salai M, Israeli A, Amit Y, Chechik A (2004) Total hip arthroplasty after avascular necrosis of the femoral head: does etiology affect the results? Arch Orthop Trauma Surg 124(2):82–85

    Article  PubMed  Google Scholar 

  6. Gardeniers JWM (1993) ARCO (Association Research Circulation Osseous) international classification of osteonecrosis. ARCO Committee on Terminology and Staging. Report on the committee meeting at Santiago de Compostella. ARCO Newsl 5:79–82

    Google Scholar 

  7. Garino JP, Steinberg ME (1997) Total hip arthroplasty in patients with avascular necrosis of the femoral head: a 2- to 10-year follow-up. Clin Orthop 334:108–115

    PubMed  Google Scholar 

  8. Goffin E, Baertz G, Rombouts JJ (2006) Long-term survivorship analysis of cemented total hip replacement (THR) after avascular necrosis of the femoral head in renal transplant recipients. Nephrol Dial Transpl 21(3):784–788

    Article  Google Scholar 

  9. Goker B, Block JA (2006) Risk of contralateral avascular necrosis (AVN) after total hip arthroplasty (THA) for non-traumatic AVN. Rheumatol Int 26(3):215–219

    Article  PubMed  Google Scholar 

  10. Gonzalez MH, Ortinau ET, Buonanno W, Prieto J (1997) Cementless total hip arthroplasty in patients with advanced avascular necrosis. J South Orthop Assoc 6(3):162–168

    PubMed  CAS  Google Scholar 

  11. Hungerford DS (1990) Role of core decompression as treatment method for ischemic femur head necrosis. Orthopade 19:219–223

    PubMed  CAS  Google Scholar 

  12. Katz RL, Bourne RB, Rorabeck CH, McGee H (1992) Total hip arthroplasty in patients with avascular necrosis of the hip: follow-up observations on cementless and cemented operations. Clin Orthop 281:145–151

    PubMed  Google Scholar 

  13. Kawasaki M, Masegawa Y, Sakano S, Masui T, Ishiguro N (2005) Total hip arthroplasty after failed transtrochanteric rotational osteotomy for avascular necrosis of the femoral head. J Arthroplast 20(5):574–579

    Article  Google Scholar 

  14. Kim SY, Kim YG, Kim PT, Ihn JC, Cho BC, Koo KH (2005) Vascularized compared with nonvascularized fibular grafts for large osteonecrotic lesions of the femoral head. J Bone Joint Surg Am 87:2012–2018

    Article  PubMed  Google Scholar 

  15. Kim VM, Oh HC, Kini HJ (2000) The pattern of bone marrow edema on MRI in osteonecrosis of the femoral head. J Bone Joint Surg Br 82:837–841

    Article  PubMed  CAS  Google Scholar 

  16. Langlais F, Fourastier J (1997) Rotation osteotomies for osteonecrosis of the femoral head. Clin Orthop 343:110–123

    PubMed  Google Scholar 

  17. Learmouth ID, Maloon S, Dall G (1990) Core decompression for early atraumatic osteonecrosis of the femoral head. J Bone Joint Surg Br 72:387–390

    Google Scholar 

  18. Lin PC, Wang CJ, Yang KD, Wang FS, Ko JY, Huang CC (2006) Extracorporeal shockwave treatment of osteonecrosis of the femoral head in systemic lupus erythematosus. J Arthroplast 21(6):911–915

    Article  Google Scholar 

  19. Ludwig J, Lauber S, Lauber HJ et al (2001) High-energy shock wave treatment of femoral head necrosis in adults. Clin Orthop 387:119–126

    Article  PubMed  Google Scholar 

  20. Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C (2003) Substance P and prostaglandin E2 release after shockwave application to the rabbit femur. Clin Orthop 406:237–245

    Article  PubMed  Google Scholar 

  21. McCormack D, Lane H, McElwain J (1996) The osteogenic potential of extracorporeal shock wave therapy: an in-vivo study. Ir J Med Sci 165:20–22

    Article  PubMed  CAS  Google Scholar 

  22. Mont MA, Jones LC, Hungerford DS (2006) Nontraumatic osteonecrosis of the femoral head: ten years later. J Bone Joint Surg Am 88:1117–1132

    Article  PubMed  Google Scholar 

  23. Ohtori S, Inoue G, Mannoji C, Saisu T, Takahashi K, Mitsuhashi S (2001) Shockwave application to rat skin induces degeneration and reinnervation of sensory nerve fibers. Neurosci Lett 315:57–60

    Article  PubMed  CAS  Google Scholar 

  24. Ohzono K, Saito M, Takaoka K, Saito S, Nishina T, Kadowaki T (1991) Natural history of nontraumatic avascular necrosis of the femoral head. J Bone Joint Surg Br 73:68–72

    PubMed  CAS  Google Scholar 

  25. Phillips FM, Pottenger LA, Finn HA, Vandermolen J (1994) Cementless total hip arthroplasty in patients with steroid-induced avascular necrosis of the hip: a 62-month follow-up study. Clin Orthop 303:147–154

    PubMed  Google Scholar 

  26. Schneider W, Knahr K (2004) Total hip replacement in younger patients: survival rate after avascular necrosis of the femoral head. Acta Orthop Scan 75(2):142–146

    Article  Google Scholar 

  27. Vande Berg BE, Malghem JJ, Labaisse MA, Noel HM, Maldague BE (1993) MR imaging of avascular necrosis and transient marrow edema of the femoral head. Radiographics 13:501–520

    Google Scholar 

  28. Wang CJ, Hung HY, Pai CH (2002) Shock wave-enhanced neovascularization at the tendon-bone junction: an experiment in dogs. J Foot Ankle Surg 41:16–22

    Article  PubMed  CAS  Google Scholar 

  29. Wang CJ, Wang FS, Huang CC, Yang KD, Weng LH, Huang HY (2005) Treatment of osteonecrosis of the femoral head—comparison of extracorporeal shockwave and core decompression and bone grafting. J Bone Joint Surg Am 87:2380–2387

    Article  PubMed  Google Scholar 

  30. Wang CJ, Wang FS, Ko JY, Huang HY, Chen CJ, Sun YC, Yang YJ (2008) Extracorporeal shockwave shows regeneration effects in hip necrosis. Rheumatology 47:542–546

    Article  PubMed  Google Scholar 

  31. Wang CJ, Wang FS, Yang KD, Huang CS, Hsu CC (2003) Shock wave therapy induces neovascularization at the tendon-bone junction: a study in rabbits. J Orthop Res 21:984–989

    Article  PubMed  Google Scholar 

  32. Wang CJ, Yang KD, Wang FS, Chen HS, Chen HH, Hsu CC (2004) Shock wave therapy enhances bone mass and bone strength after fracture of the femur: a study in rabbits. Bone 34:225–230

    Article  PubMed  Google Scholar 

  33. Wang FS, Wang CJ, Huang HC et al (2001) Physical shock wave mediates membrane hyperpolarization and Ras activation for osteogenesis in human bone marrow stromal cells. Biochem Biophys Res Commun 287:648–655

    Article  PubMed  CAS  Google Scholar 

  34. Wang FS, Wang CJ, Sheen-Chen SM et al (2002) Superoxide mediates shock wave induction of RRK-dependent osteogenic transcription factor (CBFA 1) and mesenchymal cells differentiation toward osteoprogenitors. J Biol Chem 277(3):10931–10937

    Article  PubMed  CAS  Google Scholar 

  35. Wang FS, Yang KD, Wang CJ et al (2002) Extracorporeal shock wave promotes bone marrow stromal cell growth and differentiation toward osteoprogenitors associated with TGF-β1 induction. J Bone Joint Surg Br 84:457–461

    Article  PubMed  CAS  Google Scholar 

  36. Wei SY, Kliemkiewicz JJ, Lai M, Garino JP, Steinberg ME (1999) Revision total hip arthroplasty in patients with avascular necrosis. Orthopedics 22(8):747–757

    PubMed  CAS  Google Scholar 

  37. Yang C, Heston WDW, Gulati S, Fair WR (1988) The effect of high-energy shock waves (HESW) on human bone marrow. Urol Res 16:427–429

    Article  PubMed  CAS  Google Scholar 

  38. Zangger P, Gladman DD, Urowitz MB, Bogoch ER (2000) Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. J Rheumatol 27(4):919–923

    PubMed  CAS  Google Scholar 

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Acknowledgments

Funds were received in total or partial support for the research or clinical study presented in this article. The funding sources were from Chang Gung Research Fund (CMRPG850301) and National Science Council (92-2314-B-182A-100).

Conflict of interest statement

The authors declared that they did not receive any honoraria or consultancy fees for writing this manuscript. One author (Wang CJ) has served as a member of the scientific advisory board of Sanuwave, Alpharetta, GA. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Chang Gung University College of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung, 833, Taiwan

    June-Ming Chen, Shan-Ling Hsu, To Wong, Wen-Yi Chou & Ching-Jen Wang

  2. Department of Medical Research, Chang Gung University College of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung, Taiwan

    Feng-Sheng Wang

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  1. June-Ming Chen
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  2. Shan-Ling Hsu
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  3. To Wong
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Correspondence to Ching-Jen Wang.

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Chen, JM., Hsu, SL., Wong, T. et al. Functional outcomes of bilateral hip necrosis: total hip arthroplasty versus extracorporeal shockwave. Arch Orthop Trauma Surg 129, 837–841 (2009). https://doi.org/10.1007/s00402-008-0812-6

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  • DOI: https://doi.org/10.1007/s00402-008-0812-6

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