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High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head

BACKGROUND: Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. METHODS: Fi...

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Autores principales: Xie, Kai, Mao, Yuanqing, Qu, Xinhua, Dai, Kerong, Jia, Qingwei, Zhu, Zhenan, Yan, Mengning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797389/
https://www.ncbi.nlm.nih.gov/pubmed/29394948
http://dx.doi.org/10.1186/s13018-017-0705-x
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author Xie, Kai
Mao, Yuanqing
Qu, Xinhua
Dai, Kerong
Jia, Qingwei
Zhu, Zhenan
Yan, Mengning
author_facet Xie, Kai
Mao, Yuanqing
Qu, Xinhua
Dai, Kerong
Jia, Qingwei
Zhu, Zhenan
Yan, Mengning
author_sort Xie, Kai
collection PubMed
description BACKGROUND: Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. METHODS: Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I–III nontraumatic ONFH, according to the Association Research Circulation Osseous (ARCO) system, were reviewed in the current retrospective study. The visual analog pain scale (VAS), Harris hip score, radiography, and magnetic resonance imaging were used to estimate treatment results. The progression of ONFH was evaluated by imaging examination and clinical outcomes. The results were classified as clinical success (no progression of hip symptoms) and imaging success (no progression of stage or substage on radiography and MRI). RESULTS: The mean follow-up duration was 130.6 months (range, 121 to 138 months). The mean VAS decreased from 3.8 before ESWT to 2.2 points at the 10-year follow-up (p < 0.001). The mean Harris hip score improved from 77.4 before ESWT to 86.9 points at the 10-year follow-up. The clinical success rates were 87.5% in ARCO stage I patients, 71.4% in ARCO stage II patients, and 75.0% in ARCO stage III patients. Imaging success was observed in all stage I hips, 64.3% of stage II hips, and 12.5% of stage III hips. Seventeen hips showed progression of the ARCO stage/substage on imaging examination. Eight hips showed femoral head collapse at the 10-year follow-up. Four hips in ARCO stage III and one hip in ARCO stage II were treated with total hip arthroplasty during the follow-up. Three were performed 1 year after ESWT, one at 2 years, and one at 5 years. CONCLUSIONS: The results of the current study indicated that ESWT is an effective treatment method for nontraumatic ONFH, resulting in pain relief and function restoration, especially for patients with ARCO stage I–II ONFH.
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spelling pubmed-57973892018-02-12 High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head Xie, Kai Mao, Yuanqing Qu, Xinhua Dai, Kerong Jia, Qingwei Zhu, Zhenan Yan, Mengning J Orthop Surg Res Research Article BACKGROUND: Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. METHODS: Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I–III nontraumatic ONFH, according to the Association Research Circulation Osseous (ARCO) system, were reviewed in the current retrospective study. The visual analog pain scale (VAS), Harris hip score, radiography, and magnetic resonance imaging were used to estimate treatment results. The progression of ONFH was evaluated by imaging examination and clinical outcomes. The results were classified as clinical success (no progression of hip symptoms) and imaging success (no progression of stage or substage on radiography and MRI). RESULTS: The mean follow-up duration was 130.6 months (range, 121 to 138 months). The mean VAS decreased from 3.8 before ESWT to 2.2 points at the 10-year follow-up (p < 0.001). The mean Harris hip score improved from 77.4 before ESWT to 86.9 points at the 10-year follow-up. The clinical success rates were 87.5% in ARCO stage I patients, 71.4% in ARCO stage II patients, and 75.0% in ARCO stage III patients. Imaging success was observed in all stage I hips, 64.3% of stage II hips, and 12.5% of stage III hips. Seventeen hips showed progression of the ARCO stage/substage on imaging examination. Eight hips showed femoral head collapse at the 10-year follow-up. Four hips in ARCO stage III and one hip in ARCO stage II were treated with total hip arthroplasty during the follow-up. Three were performed 1 year after ESWT, one at 2 years, and one at 5 years. CONCLUSIONS: The results of the current study indicated that ESWT is an effective treatment method for nontraumatic ONFH, resulting in pain relief and function restoration, especially for patients with ARCO stage I–II ONFH. BioMed Central 2018-02-02 /pmc/articles/PMC5797389/ /pubmed/29394948 http://dx.doi.org/10.1186/s13018-017-0705-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Xie, Kai
Mao, Yuanqing
Qu, Xinhua
Dai, Kerong
Jia, Qingwei
Zhu, Zhenan
Yan, Mengning
High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
title High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
title_full High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
title_fullStr High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
title_full_unstemmed High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
title_short High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
title_sort high-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797389/
https://www.ncbi.nlm.nih.gov/pubmed/29394948
http://dx.doi.org/10.1186/s13018-017-0705-x
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