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Chinese Expert Consensus on Clinical Diagnosis and Treatment Technique of Osteonecrosis of the Femoral Head (2023)

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Original Article | Vol 3 | Issue 2 |  July-December 2023 | page: 14-21 | Wei Sun, Fuqiang Gao, Zirong Li, Xin Xu, Jike Lu

DOI: https://doi.org/10.13107/jrs.2023.v03.i02.93

Author: Wei Sun [1, 2], Fuqiang Gao [1], Zirong Li [1], Xin Xu [1], Jike Lu [1]

[1] Centre for Osteonecrosis and Joint-Preserving and Reconstruction, Department of Orthopedics, China-Japan Friendship Hospital, Beijing, 100029, China.
[2] Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Address of Correspondence
Dr. Wei Sun,
Centre for Osteonecrosis and Joint-Preserving and Reconstruction, Department of Orthopedics, China-Japan Friendship Hospital, Beijing, 100029, China. /Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia,
Pennsylvania, USA.
E-mail: lizirongon@163.com

Abstract

Osteonecrosis of the femoral head (ONFH) is a common and refractory disease. Although the exact pathophysiological mechanism is not fully understood, it is believed to be closely related to the interruption of intra-bone circulation and eventual bone tissue death. The prevention and treatment of ONFH are always a great challenge for orthopedists. The diagnostic level of ONFH has been continuously improved with the development of imaging techniques such as magnetic resource imaging and the in-depth understanding of the disease in recent years. There are many treatment methods for ONFH, which are generally considered individually and comprehensively according to factors such as the patient’s age, osteonecrosis stage, classification, and compliance with joint-sparing treatment. There is currently no unified standard. ONFH staging and classification play an important reference value for doctors to choose treatment options. In recent years, based on the characteristics of ONFH in Chinese people, the academic community has proposed Chinese staging and China-Japan Friendship Hospital classification. The consensus also introduces them together with the international ARCO staging to provide guidance for individualized treatment of ONFH. To further standardize the diagnosis of ONFH and expand the treatment of ONFH, the Association Related to Osseous Microcirculation Chinese Microcirculation Society organized domestic experts in the field of ONFH to jointly formulate the expert consensus, to provide reference for the standardized diagnosis of ONFH and the selection of individualized diagnosis and treatment techniques.
Keywords: Expert consensus, Osteonecrosis of the femoral head, Diagnosis, Treatment technique

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How to Cite this article: Sun W, Gao F, Li Z, Xu X | Chinese Expert Consensus on Clinical Diagnosis and Treatment Technique of Osteonecrosis of the Femoral Head (2023). | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 14-21.

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Analysis of therapeutic effect of high focused extracorporeal shock wave comprehensive therapy on femoral head bone marrow edema syndrome

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Original Article | Vol 3 | Issue 2 |  July-December 2023 | page: 35-40 | Ruimeng Duan, Leilei Zhang, Haonan Ling, Jie Guan, Huisheng Shi, Dawei Liang, Xiantao Chen

DOI: https://doi.org/10.13107/jrs.2023.v03.i02.99

Author: Ruimeng Duan [1], Leilei Zhang [1], Haonan Ling [1], Jie Guan [1], Huisheng Shi [1], Dawei Liang [1], Xiantao Chen [1]

[1] Department of Femoral Head Necrosis, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, Henan, China.

Address of Correspondence
Dr. Xiantao Chen,
Department of Femoral Head Necrosis, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), No. 82 Qiming South Road, Luoyang, Henan Province 471000, China.
E-mail: luoyangzhenggu@163.com

Abstract

Purpose: This study explored the clinical therapeutic effect of high-focused extracorporeal shock wave therapy (HF-ESWT) combined with exercise rehabilitation and drug therapy on femoral head bone marrow edema syndrome (BMES).
Materials and Methods: This study systematically reviewed and analyzed the clinical data of 43 patients with femoral head bone marrow edema who were treated in our hospital from January 2017 to June 2022. Twenty-three patients received HF-ESWT comprehensive treatment. Twenty patients received general treatment including medication and exercise rehabilitation treatment. The treatment methods for Group B patients were the same as Group A, except for not receiving shock wave therapy. Changes in visual analog scale (VAS), Harris score of the hip, and the edema area of region of interest area (ROIA) on hip magnetic resonance imaging (MRI) were analyzed before and after treatment.
Results: Our research found that patients receiving HF-ESWT had significantly reduced VAS compared with general treatment at 1, 2, and 3 months (P < 0.05). We found that HF-ESWT comprehensive treatment had significantly improved hip Harris score compared with general treatment at 2 and 3 months (P < 0.05). HF-ESWT comprehensive treatment had significantly reduced edema area of ROIA on hip MRI compared with general treatment at 1, 2, and 3 months (P < 0.05). In addition, the healing rate was significantly higher in the HF-ESWT
comprehensive treatment group compared with general treatment group (P < 0.05). One of the patients in the group treated with shockwaves developed hip pain that worsened after treatment, three patients developed local skin ecchymosis, and the other patients had no adverse events.
Conclusion: HF-ESWT comprehensive treatment significantly reduced hip pain symptoms, quickly shortened the time for femoral head edema to dissipate, and significantly improved hip function for affected limbs with bone marrow edema syndrome. HF-ESWT comprehensive treatment may be an effective therapeutic strategy for HF-BMES.
Keywords: Extracorporeal shock wave therapy, Bone marrow edema syndrome, Traditional Chinese medicine, Osteonecrosis of the femoral head

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How to Cite this article: Duan R, Zhang L, Ling H, Guan J, Shi H, Liang D, Chen X | Analysis of therapeutic effect of high focused extracorporeal shock wave comprehensive therapy on femoral head bone marrow edema syndrome | Journal of Regenerative Science | Jul-Dec 2023; 3(2): 35-40.

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