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Bilateral Osteonecrosis Associated with Corticosteroid Treatment: Stem Cell Therapy Versus Core Decompression in the Same Patient

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Osteonecrosis of the Femoral Head

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Abstract

This chapter presents the long-term results of stem cell therapy and core decompression in a patient with bilateral osteonecrosis of the femoral head. This case demonstrates that persistent hip pain, especially with joint movement, tenderness, or reduced range of motion, warrants magnetic resonance imaging because of the association of glucocorticoid therapy with osteonecrosis. The pathognomonic, subchondral crescent sign seen on radiographic examination may not be present in the early stages of osteonecrosis, and MRI can reveal extensive osteonecrosis before any change in the shape of the femoral head or appearance of a fracture crescent on X-rays.

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Bibliography

  1. Cushing H. The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism). Bull Johns Hopkins Hosp. 1932;50:137–95.

    Google Scholar 

  2. Boland EW, Headley NE. Management of rheumatoid arthritis with smaller (maintenance) doses of cortisone acetate. JAMA. 1950;144:365–72.

    Article  CAS  Google Scholar 

  3. Bollet AJ, Black R, Bumin JJ. Major undesirable side-effects resulting from prednisolone and prednisone. JAMA. 1955;157:459–63.

    Article  Google Scholar 

  4. Freyberg RH, Traeger CH, Patterson M, et al. Problems of prolonged cortisone treatment for rheumatoid arthritis. JAMA. 1951;147:1538–43.

    Article  CAS  Google Scholar 

  5. Heiman WG, Freiberger RH. Avascular necrosis of the femoral and humeral heads after high-dosage corticosteroid therapy. N Engl J Med. 1960;263:672–5.

    Article  Google Scholar 

  6. 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.

    Article  CAS  PubMed  Google Scholar 

  7. Hernigou P, Poignard A, Manicom O, et al. The use of percutaneous autologous bone marrow transplantation in nonunion and avascular necrosis of bone. J Bone Joint Surg Br. 2005;87(7):896.

    Article  CAS  PubMed  Google Scholar 

  8. Houdek MT, Wyles CC, Packard BD, Terzic A, Behfar A, Sierra RJ. Decreased osteogenic activity of mesenchymal stem cells in patients with corticosteroid-induced osteonecrosis of the femoral head. J Arthroplasty. 2016;31(4):893–8.

    Article  PubMed  Google Scholar 

  9. Lee HS, Huang GT, Chiang H, et al. Multipotent mesenchymal stem cells from femoral bone marrow near the site of osteonecrosis. Stem Cells. 2003;21:190.

    Article  CAS  PubMed  Google Scholar 

  10. Liberman JR. Core decompression for osteonecrosis of hip. Clin Orthop. 2004;418:29.

    Article  Google Scholar 

  11. LoCascio V, Bonucci E, Imbimbo B, et al. Bone loss in response to long-term glucocorticoid therapy. Bone Miner. 1990;8:39–51.

    Article  CAS  PubMed  Google Scholar 

  12. Lorio R, Healy WL, Abramowitz AJ, et al. Clinical outcome and survivorship analysis of core decompression for early osteonecrosis of the femoral head. J Arthroplasty. 1998;13(1):34.

    Article  Google Scholar 

  13. Mont MA, Cherian JJ, Sierra RJ, Jones LC, Lieberman JR. Nontraumatic osteonecrosis of the femoral head: where do we stand today? A ten-year update. J Bone Joint Surg Am. 2015;97(19):1604–27.

    Article  PubMed  Google Scholar 

  14. Nash JJ, Nash AG, Leach ME, et al. Medical malpractice and corticosteroid use. Otolaryngol Head Neck Surg. 2011;144:10–5.

    Article  PubMed  Google Scholar 

  15. Pietrogrande V, Mastromarino R. Osteopathia da prolungato trattmento cortisonico. Ortop Tramat. 1957;25:791–810.

    Google Scholar 

  16. Weinstein RS. Clinical practice: glucocorticoid-induced bone disease. N Engl J Med. 2011;365:62–70.

    Article  CAS  PubMed  Google Scholar 

  17. Wyles CC, Houdek MT, Behfar A, Sierra RJ. Mesenchymal stem cell therapy for osteoarthritis: current perspectives. Stem Cells Cloning. 2015;8:117–24.

    PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. University Paris East, Department of Orthopaedic Surgery, 51 avenue du Maréchal de Lattre de Tassigny, 94010, cedex, Créteil, France

    Philippe Hernigou MD (Professor of Orthopaedic Surgery), Arnaud Dubory MD, Damien Potage MD & Charles Henri Flouzat Lachaniette MD

Authors
  1. Philippe Hernigou MD
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  2. Arnaud Dubory MD
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  3. Damien Potage MD
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  4. Charles Henri Flouzat Lachaniette MD
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Corresponding author

Correspondence to Philippe Hernigou MD .

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Editors and Affiliations

  1. Mayo Clinic, Rochester, Minnesota, USA

    Rafael J. Sierra

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© 2017 Mayo Foundation for Medical Education and Research

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Hernigou, P., Dubory, A., Potage, D., Lachaniette, C.H.F. (2017). Bilateral Osteonecrosis Associated with Corticosteroid Treatment: Stem Cell Therapy Versus Core Decompression in the Same Patient. In: Sierra, R. (eds) Osteonecrosis of the Femoral Head. Springer, Cham. https://doi.org/10.1007/978-3-319-50664-7_5

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  • DOI: https://doi.org/10.1007/978-3-319-50664-7_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50662-3

  • Online ISBN: 978-3-319-50664-7

  • eBook Packages: MedicineMedicine (R0)

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