Treatment of osteonecrosis of the femoral head by botulinum toxin type A injection to the psoas muscle: A case report.
10.17085/apm.2017.12.1.85
- Author:
Sung Yul KIM
1
;
Dong Hyun LEE
;
Sun Hee KIM
;
Yong Hyun CHO
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul Sungsim General Hospital, Seoul, Korea. anesthecho@naver.com
- Publication Type:Case Report
- Keywords:
Botulinum toxins Type A;
Femur head necrosis;
Psoas muscle
- MeSH:
Botulinum Toxins*;
Botulinum Toxins, Type A*;
Classification;
Depression;
Femur Head Necrosis;
Head*;
Hip;
Humans;
Mefenamic Acid;
Osteonecrosis*;
Psoas Muscles*
- From:Anesthesia and Pain Medicine
2017;12(1):85-90
- CountryRepublic of Korea
- Language:English
-
Abstract:
Osteonecrosis of the femoral head (ONFH) can cause femoral head depression and cortical discontinuity. Treatment for ONFH remains challenging. We performed botulinum toxin type A injection to psoas major muscle in five patients with radiological femoral head collapse (Association Research Circulation Osseus classification stage III) who were non-responsive after two years of conservative treatment (tramadol 200 mg/day, mefenamic acid 1,000 mg/day). At two weeks after the procedure, their mean hip pain was decreased from 88 ± 0.4/100 mm to 22 ± 0.4/100 mm based on visual analogue scale (VAS). The pain was maintained at a minimum of 20/100 mm and a maximum of 30/100 mm in VAS for at least six weeks after the procedure. These values were mean ± SD. These patients were followed-up for 6 months. There was no exacerbation of pain from repeated (three times) botulinum toxin type A injection to the psoas major muscle.
