Osteonecrosis of the femoral head a clinical casebook 1st

Rafael J Sierra Editor Osteonecrosis of the Femoral Head A Clinical Casebook 123 Osteonecrosis of the Femoral Head Rafael J Sierra Editor Osteonecrosis of the Femoral Head A Clinical Casebook Editor Rafael J Sierra Mayo Clinic Rochester, Minnesota, USA ISBN 978-3-319-50662-3 ISBN 978-3-319-50664-7 (eBook) DOI 10.1007/978-3-319-50664-7 Library of Congress Control Number: 2017936710 © Mayo Foundation for Medical Education and Research 2017 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface This first edition of Osteonecrosis of the Femoral Head: A Clinical Casebook assembles the various treatment options available for management of osteonecrosis of the femoral head (ONFH) Its goal is to provide the practicing hip surgeon and medical practitioner with an easy-to-read, case- based discussion on the modern treatment of ONFH, with special emphasis on early or pre-collapse stages The prevalence of ONFH seems to be on the rise and related to the medical treatment of life-threatening conditions such as cancers, organ transplantation, and/or treatment of rheumatologic conditions with a combination of steroid regimens The condition affects very young patients and unfortunately still carries a fairly poor prognosis if left untreated Diagnosing the condition early will give us the option of treating this condition in early stages in order to delay or avoid completely total hip arthroplasty (THA) Although THA is an option for late-stage ON, it is imperative for us to understand the pros and cons of the various surgical procedures that have been performed around the world for the management of early-stage ON in an effort to provide pain relief and delay progression This book compiles a number of treatment options for management of early-stage ON. Furthermore, the treatment of post-collapse ON is discussed, presenting cases of several salvage procedures or THA We gathered leaders from around the world to discuss the surgical treatment for this condition and their outcomes In each chapter, a description of the patient, the work-up and diagnosis, and surgical strategies are presented, with an v vi Preface in-depth discussion of the potential pitfalls or complications that can occur with each procedure The reader will therefore obtain the knowledge required for managing the patient and understand the surgical technique and complexity of the procedure to be performed The innovative format of this book represents the future of medical education More and more conferences are moving toward case-based format education as it represents for the clinician a real-life situation that is easy to remember and learn This is the first book to gather the combined international experience for treatment of ON, uniting treatment recommendations across three continents I have to thank the chapter authors for their expertise, for their lifelong journey in studying and treating this difficult condition, and certainly for dedicating the time that was required to write the chapters I would like to acknowledge the support and assistance of Springer and their contributors for the organization of the chapters and dedicate this book to my wife, Victoria, and my two children, Sofia and Rafico, for their continued support throughout the years Rochester, MN, USA Rafael J. Sierra Contents Part I Pre-collapse: Treatment of Early Stage Osteonecrosis 1 Osteonecrosis and Thrombophilia: Pathophysiology, Diagnosis, and Treatment�� Charles J Glueck, Ping Wang, and Richard A Freiberg 2 Bisphosphonates�� 19 Hamed Vahedi and Javad Parvizi 3 Successful Decompression with Multiple Percutaneous Drilling�� 27 Todd P Pierce, Julio J Jauregui, Jeffrey J Cherian, Randa K Elmallah, and Michael A Mont 4 Simultaneous Cell Therapy Preserving Surgery and Contralateral Arthroplasty for Bilateral Hip Osteonecrosis�� 33 Philippe Hernigou, Arnaud Dubory, Damien Potage, and Charles Henri Flouzat Lachaniette 5 Bilateral Osteonecrosis Associated with Corticosteroid Treatment: Stem Cell Therapy Versus Core Decompression in the Same Patient�� 43 Philippe Hernigou, Arnaud Dubory, Damien Potage, and Charles Henri Flouzat Lachaniette vii viii Contents 6 Minimally Invasive Core Decompression Augmented with Concentrated Autologous Mesenchymal Stem Cells�� 53 Matthew T Houdek 7 Core Decompression and Bone Marrow Stem Cell Injection�� 67 Hamed Vahedi and Javad Parvizi 8 Osteonecrosis of the Femoral Head�� 75 William C Pannell and Jay R Lieberman 9 Bilateral Hip Decompression Using X-REAM® and PRO-DENSE®�� 95 Eric M Greber, Paul K Edwards, and C Lowry Barnes 10 Surgical Dislocation and Osteochondral Autograft Transfer System (OATS) as Salvage of Failed Core Decompression Complicated by Femoral Head Penetration�� 107 Cody C Wyles and Rafael J Sierra Part II Late Pre-Collapse or Post-Collapse: Head Preserving 11 Nonvascularized Bone Grafting�� 117 Todd P Pierce, Julio J Jauregui, Jeffrey J Cherian, Randa K Elmallah, and Michael A Mont 12 Bilateral Nonvascularized Bone Grafting�� 123 Todd P Pierce, Julio J Jauregui, Jeffrey J Cherian, Randa K Elmallah, and Michael A Mont 13 Femoral Head Decompression Using the X-REAM® Followed by Autologous Tibial Cancellous Bone Impaction�� 129 Stefan B Keizer and Rob G H H Nelissen Contents ix 14 Autologous Osteochondral Transfer for Management of Femoral Head Osteonecrosis�� 141 J Ryan Martin and Rafael J Sierra 15 Long-Term Result of Hip Decompression and Vascularized Fibula for Steinberg Stage IV AVN�� 157 Vasili Karas, Patrick Millikan, and Samuel Wellman 16 Bone Grafting Pedicled with Femoral Quadratus for Alcohol-Induced Osteonecrosis of the Femoral Head�� 175 Yisheng Wang 17 Transtrochanteric Anterior Rotational Osteotomy of the Femoral Head for Treatment of Osteonecrosis Affecting the Hip�� 189 Cody C Wyles, Rafael J Sierra, and Robert T Trousdale Part III Post-collapse: Arthroplasty and Complications 18 Systemic Lupus Erythematosus Patient Requiring THA�� 201 Todd P Pierce, Julio J Jauregui, Jeffrey J Cherian, Randa K Elmallah, and Michael A Mont 19 Attempted Bone Grafting Converted Intraoperatively to THA�� 209 Todd P Pierce, Julio J Jauregui, Jeffrey J Cherian, Randa K Elmallah, and Michael A Mont 20 All Osteonecroses Are Not Predictor of Poor Outcome with Cemented Total Hip Arthroplasty: A 30-Year Follow-Up Case Presentation with Bilateral Ceramic on Ceramic Bearing Surface�� 217 Philippe Hernigou, Arnaud Dubory, Damien Potage, and Charles Henri Flouzat Lachaniette x Contents 21 Complications of Uncemented Total Hip Arthroplasty: Success�� 225 Carlos J Lavernia, Michele D’Apuzzo, and Jesus M Villa 22 Complications of Uncemented Total Hip Arthroplasty: Failure�� 237 Michele D’Apuzzo, Carlos J Lavernia, and Jesus M Villa Index�� 253 242 M D’Apuzzo et al Figure 22.4 Lateral radiograph of the left hip obtained approximately 3 months after cementless total hip arthroplasty results without complaints Two years after the reimplantation, there was no pain and the walking distance was unlimited The Harris Hip Score was 95 and the patient was satisfied with the procedure Chapter 22. Complications of Uncemented 243 Figure 22.5 Anteroposterior radiograph of the left hip obtained before implant removal 244 M D’Apuzzo et al Figure 22.6 Anteroposterior radiograph of the left hip showing articulating spacer in place Literature Review Contemporary series [1, 2] have demonstrated excellent results obtained with the use of total hip arthroplasty when performed for femoral head osteonecrosis The general Chapter 22. Complications of Uncemented 245 Figure 22.7 Anteroposterior radiograph of the left hip demonstrating dislocation of the spacer 246 M D’Apuzzo et al Figure 22.8 Anteroposterior radiograph of the left hip after removal of the spacer association of poor outcomes with THA performed in patients with this diagnosis belongs to the past Nevertheless, the results of the arthroplasty are still dependent on the original disease responsible for the osteonecrosis of the femoral head The deep infection case illustrated here might as well occur with a primary THA performed for any other diagnosis, but this particular complication should always be considered Chapter 22. Complications of Uncemented 247 Figure 22.9 Lateral radiograph of the left hip after spacer removal in those cases performed in patients with osteonecrosis associated with sickle cell disease or immunologic conditions although excellent results can still be achieved in these Woo et al [3] studied a series of 19 THAs performed in 13 patients diagnosed with osteonecrosis and systemic lupus erythematosus (SLE) The results of these cases where compared with a control group of patients with osteonecrosis but without SLE. The authors found no significant differences in the Harris Hip Scores between both groups Further, there were no infections or any other significant complication related to 248 M D’Apuzzo et al Figure 22.10 Anteroposterior radiograph of the left hip obtained after reimplantation of the total hip arthroplasty Chapter 22. Complications of Uncemented 249 Figure 22.11 Lateral radiograph of the reimplantation of the left total hip arthroplasty the surgery Issa et al [4] compared 32 sickle cell patients (42 hips) with 87 non-sickle cell osteonecrosis patients (102 hips) and found that there were no significant differences in aseptic prosthesis survivorship, Harris Hip scores, SF-36, or on radiographic findings There was no deep infection in the non- sickle cell osteonecrosis group, but in the sickle cell 250 M D’Apuzzo et al cohort, two patients were revised due to septic loosening at about 6 months and 13 months after the index surgery A twostage exchange revision surgery was performed successfully in both cases, and a Harris Hip Score greater than 80 points was achieved after the reimplantation (similar to our case) Hernigou et al [5] retrospectively reviewed 312 arthroplasties performed in 244 patients diagnosed with sickle cell disease with a minimum follow-up of 5 years The authors observed a rate of late infection of 3% (10/312) A two-stage exchange revision was performed for infection 45 days after removal of the initial arthroplasty At the latest follow-up, eight of the ten hips had no infection but two had recurrence of it In summary, complications due to infection seem to be more prevalent in those patients diagnosed with osteonecrosis and immunologic conditions and/or sickle cell disease The rates of deep infection are particularly concerning However, due to the excellent results achieved in some series, the risk- to-benefit ratio seems to be reasonable and total hip arthroplasty remains a valid option even for these patients Sickle cell disease patients undergoing THA need a special and complex perioperative workup Patients should have a complete hematologic evaluation including antibody screening before surgery All blood products should be typed for ABO, Rhesus, and Kell to prevent antigen mismatch during transfusions Red blood cell exchange (aimed to decrease hemoglobin S level to less than 30%) should be considered in those patients with a history of acute chest syndrome, cerebrovascular episode, or severe anemia (