Appearance of proteomics technology can fleetly filt and reveal specificity biomarkers of disease, this will help to reveal the pathogenesis of femur head necrosis and help early diagnosis, find more effective methods and therapeutic targets. At present, they are hot spots that find out the occurred mechanism,related proteins of early diagnosis and early treatment and its functional identification; set up the early related database; optimize the protein extraction methods for research of femur head necrosis. This article reviews the application of study technology of related proteins of femur head necrosis on bone tissue, serum,related animal model,and in order to provide further research ideas.
Early Diagnosis ; Femur Head Necrosis ; diagnosis ; metabolism ; Humans ; Proteomics ; methods

Chronic myelogenous leukemia (CML) is a malignant clonal disorder of hemopoietic stem cells characterized by abnormal proliferation and accumulation of immature granulocyte. Leukostasis is one of the complications of CML and is characterized by partial or total occlusion of microcirculation by aggregation of leukemic cells and thrombi leading to respiratory, ophthalmic or neurologic symptoms. We experienced a rare case of avascular necrosis of the femoral head as the initial presentation of chronic myelogenous leukemia. A 24-year-old male patient was admitted to our hospital with pain in the right hip joint. The patient was diagnosed to be suffering from chronic myelogenous leukemia by packed marrow with granulocytic and megakaryocytic hyperplasia and the presence of Philadelphia chromosome. The right hip joint pain was attributed to avascular necrosis of the femoral head. And the avascular necrosis could be considered as the complication of chronic myelogenous leukemia due to microcirculatory obstruction of the femoral head. The avascular necrosis of the right femoral head was treated with bipolar hemiarthoplasty.
Male ; Leukemia, Myeloid, Chronic/*diagnosis/physiopathology ; Humans ; Femur Head Necrosis/*diagnosis/physiopathology ; Adult

PURPOSE: To analyze diagnostic process and clinical data in cases of fracture of the femoral shaft with fracture of the proximal femur. MATERIALS AND METHODS: We reviewed 24 cases of patient who undergone surgery for fracture of the femoral shaft with ipsilateral fracture of the proximal femur and more than 1 year of examination of follow up was available. Age, sex.location and classification of the fracture, the time of diagnosis and operation, the method of operation, the associated injuries, the time of bony union and complication were investigated, postoperative function was evaluated on Friedman and Wyman criteria. RESULTS: Bony union showed significant difference in the displacement and comminution of fracture, postoperative function revealed significant difference according to the associated injuries. The 6 cases (25%) out of 24 cases are failed early diagnosis, 4 cases out of 6 cases was detected during operation and 2cases was found after surgery. 21 cases out of 24 cases of femoral shaft fractures showed union, 23 cases out of 24 cases of femoral neck fractures showed union. There were eleven good, eleven fair, and two poor functional result according to Friedman and Wyman criteria. CONCLUSION: Precious clinical and radiologic examination is needed not to miss the diagnosis of proximal femur fractures in ipsilateral femoral shaft fractures with proximal femur fractures. Anatomical reduction and rigid fixation of proximal femur are important to reduce avascular necrosis of femoral head and nonunion of proximal femoral fractures.
Displacement (Psychology) ; Early Diagnosis ; Femoral Fractures ; Femoral Neck Fractures ; Femur ; Follow-Up Studies ; Head ; Humans ; Necrosis

Osteonecrosis of the femoral head is a common clinical orthopedic disease. The progression of the disease is rapid and the prognosis is poor. All the medical profession recognize it as one of the unresolved medical problems. Biomechanical factors play an important role in the course of progression and treatment of osteonecrosis of the femoral head. In this paper, we review the literature and introduce the advanced biomechanical studies on the symptoms, image, collapse, collapse prediction, preserving femoral head surgery of osteonecrosis of the femoral head.
Biomechanical Phenomena ; Femur Head Necrosis ; diagnosis ; metabolism ; pathology ; surgery ; Humans ; Prognosis

Bone Diseases ; Diagnosis, Differential ; Femur Head Necrosis ; Humans ; Medicine, Chinese Traditional ; methods ; Osteoporosis

Although the incidence of avascular necrosis of the pmximal end of the femur has declined by early diagnosis and gentle dynamic reduction, it is still one of the major complication in treatment of congenital dislocation of the hip. From 65 cases, followed up at least one year after reduction at the Department of Orthopaedic Surgery, Busan National University Hospital from January, 1980 to June, 1984, the authom studied the factom causing avascular necrosis of the femoral head and its radiographic classification. The following results were obtained. 1. Based on Salter's criteria, avascular necrosis of the femoral head was considered in 16 of the 65 hips, a rate of 24.6%. 2. Based on the classification of Bucholz and Ogden, radiographic patterns of avascular necrosis were: type 1, 6(37.5%); type 2,3(18.8%); type 3, 5(31.3%); type 4, 2(12.5%). 3. Generally, the older the child when treatment was initiated, the more likely was avascular necrosis to develop, and the more severe was its damage. 4. The incidences of avascular necrosis in various treatments were: Pavlik harness, 10%; manipulative reduction, 17%; medial approach open reduction 40%; Salters innominate osteotomy only, 36%; femoral osteotomy with pelvic osteotomy, 20%. The high incidence in medial approach open reduction and Salters innominate osteotomy may be due to failure of previous manipulative reduction. 5. The preliminary traction of 14 days or more substantially reduced the incidence of avascular necrosis. 6. There was particularly high incidence of avascular necrosis in cast immobilization of Lorenz position. 7. The correlation between adductor tenotomy and avascular necrosis was not noticed. There was no avascular necrosis in the normal contralateral hip after cast immobilization.
Busan ; Child ; Classification ; Dislocations ; Early Diagnosis ; Femur ; Head ; Hip ; Humans ; Immobilization ; Incidence ; Necrosis ; Osteotomy ; Tenotomy ; Traction

OBJECTIVE: To explore the therapeutic effect of multiple small diameter drilling combined with extracorporeal shock wave therapy (ESWT) under C-arm X-raylocalization in patients with early osteonecrosis of the femoral head (ONFH). METHODS: A total of 106 cases of early ONFH patients admitted from May 2015 to May 2017 were retrospectively selected as the study subjects. According to different treatment methods, the patients were divided into observation group and control group, 53 cases in each group. The observation group was treated with multiple small-diameter drilling combined with ESWT under C-arm positioning in the observation group, including 41 males and 12 females with an age of (45.85±6.01) years old (22 to 70 years old);and the control group was treated with ESWT, including 34 males and 19 females with an age of (45.12±5.83) years old(20 to 68 years old) in the control group. The modified Harris hip scores(mHHS), visual analog scale(VAS), hip flexion range, hip abduction and adduction range, ONFH area ratio and clinical efficacy were compared between twe groups before and after treatment. Kaplan-Meier method was used to draw a survival curve to compare the femoral head survival rate between two groups during the 3-year follow-up period after treatment. RESULTS: There were no complications such as poor wound healing and infection. All of 106 patients were followed up for 28 to 36 months with an average of (31.06±4.28) months. MHHS score, hip flexion range and hip abduction and adduction range in the observation group were increased from (63.85±5.42) scores, (23.79±2.21) °, (32.40±4.19) ° before treatment to (85.51±5.69) scores, (34.65±2.73)°, (43.32±5.71)° at 2 years after treatment, respectively(P<0.05). The above indicators in the control group increased from (64.73±5.64)°, (23.82±2.18)°, (32.45±4.13)° before treatment to (81.65±5.48) scores, (32.79±2.87)°, (39.75±5.68)°at two years after treatment, respectively(P<0.05). VAS score and ONFH area ratio in the observation group decreased from (5.76±1.41) scores and (35.07±4.96)% before treatment to (3.39±1.02) scores and (22.04±3.23)% at 2 years after treatment, respectively(P<0.05). The above indicatiors in control group decreased from (5.73±1.45) scores and (35.24±5.18)% before treatment to (4.43±1.21) scores and (28.32±3.76)% at 2 years after treatment, respectively(P<0.05), and the improvement in the observation group was significantly higher than that in the control group(P<0.05). At 3 years after treatment, the femoral head survival rate in the observation group was higher than that in the control group (P<0.05). CONCLUSION Multiple small diameter drilling combined with ESWT under C-arm positioning can significantly improve the clinical symptoms of patients with early ONFH, relieve pain and improve clinical efficacy.
Male ; Female ; Humans ; Adult ; Middle Aged ; Young Adult ; Aged ; Femur Head ; Retrospective Studies ; Femur Head Necrosis/diagnosis* ; Extracorporeal Shockwave Therapy/methods* ; Treatment Outcome

OBJECTIVE: To analyze the clinical effect of decompression and bone grafting on osteonecrosis of the femoral head(ONFH) at different sites of necrotic lesions. METHODS: A total of 105 patients with ARCOⅡstage ONFH admitted from January 2017 to December 2018 were retrospectively analyzed. There were 71 males and 34 females, with an average age of (55.20±10.98) years old. The mean course of all patients was(15.91±9.85) months. According to Japanese Inveatigation Committee (JIC) classification, all patients were divided into 4 types:17 cases of type A, 26 cases of type B, 33 cases of type C1 and 29 cases of type C2. All four groups were treated with decompression of the pulp core and bone grafting. Visual analogue scale(VAS) and Harris hip joint score were used before and at 3, 6, 12, and 24 months after the operation, and the collapse of the femoral head was observed by X-ray examination within 2 years. RESULTS: All 105 patients were successful on operation without complications, and the mean follow-up duration was (24.45±2.75) months. Harris score showed that there was no statistical difference among four groups before surgery and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in intragroup Harris scores at preoperative and postoperative time points among four groups (P<0.01). VAS showed that there was no statistical difference among four groups before and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in VAS at preoperative and postoperative time points among four groups (P<0.01). None of the patients in four groups had femoral head collapse before and 3, 6 months after surgery. At 12 months after operation, there were 3 cases of femoral head collapse in group C and 4 cases in group C2(P>0.05);At 24 months after operation, 1 case of femoral head collapse occurred in group B, 6 cases in group C1 and 8 cases in group C2(P<0.05). CONCLUSION Core decompression and bone grafting can improve the effect of ONFH and hip preservation. The effect of hip preservation for ONFH is closely related to the location of the osteonecrosis lesion, so the influence of the location of lesion on the effect of hip preservation should be considered in clinical treatment, so as to make better preoperative hip preservation plan.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Femur Head Necrosis/diagnosis* ; Femur Head/surgery* ; Treatment Outcome ; Decompression, Surgical ; Bone Transplantation

OBJECTIVETo observe the distribution difference of magnetic resonance imaging (MRI) signals in osteonecrosis of the femoral head (ONFH) patients of different TCM syndrome types.

METHODSRecruited 29 ONFH patients were assigned to the tendon and vessel stagnation group (14 cases) and the Gan-Shen deficiency group (15 cases) according to TCM syndrome typing. The distribution difference of their MRI signals of MRIT1WI, T2WI + fs, T1 and T2 combined signal were compared.

RESULTSThere was statistical difference in T1W1 signal distribution between the two TCM syndrome types (P = 0.04). There was no statistical difference in T2WI + fs or T1 and T2 combined signal between the two TCM syndrome types (P = 0.42, P = 0.15). MRI signals in the tendon and vessel stagnation group were mainly manifested as fat-like signals,while they were mainly manifested as mixed signals in the Gan-Shen deficiency group.

CONCLUSIONDistribution difference of MRI signals exists between ONFH patients of different TCM syndrome types.

Adult ; Aged ; Diagnosis, Differential ; Female ; Femur Head Necrosis ; diagnosis ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Medicine, Chinese Traditional ; Middle Aged

What is the most effective treatment for the early stages of osteonecrosis of the femoral head? We assessed multiple drilling and stem cell implantation to treat the early stages of osteonecrosis of the femoral head. We report the clinical and radiological results of stem cell implantation and core decompression. In total, 128 patients (190 hips) who had undergone surgery were divided into two groups based on which treatment they had received: (1) multiple drilling and stem cell implantation or (2) core decompression, curettage and a bone graft. The clinical and radiographic results of the two groups were compared. At 5-year follow-up, in the stem cell implantation group, 64.3% (27/42) of the patients with Stage IIa disease, 56.7% (21/37) of the patients with Stage IIb disease and 42.9% (21/49) of the patients with Stage III disease had undergone no additional surgery. In the conventional core decompression group, 64.3% (9/14) of the patients with Stage IIa disease, 55.6% (5/9) of the patients with Stage IIb disease and 37.5% (3/8) of the patients with Stage III disease had undergone no additional surgery. Success rates were higher in patients with Ficat Stage I or II lesions than in those with Stage III lesions. There were no statistically significant differences between the groups in terms of success rate or in the clinical and radiographic results of the two methods. Essentially the same results were found with stem cell implantation as with the conventional method of core decompression.
Adolescent ; Adult ; Decompression, Surgical ; Female ; Femur Head Necrosis/diagnosis/*surgery ; Humans ; Male ; Middle Aged ; *Stem Cell Transplantation ; Treatment Outcome