Femur Başı Avasküler Nekrozunda Adjuvan Tedavi

Femur başı avasküler nekrozu (FBAVN) bir şekilde ortaya çıkmakta,  kendi kendine iyileşme veya kötüleşmeler ile seyretmekte ve en sonunda ortaya çıkabilen kalıcı hasar ile ciddi cerrahi girişimlerin yapılması gereken bir tabloya yol açabilmektedir. Güncel literatürde; bitki özlerinden tutunda ses dalgaları,kemik morfogentik protein2, iloprost, hiperbarik oksijen ve bifosfonatlarla veya bunların karışımıyla ortaya çıkan kokteyl tedavilere varıncaya kadar birçok yöntem ile deneysel ve klinik araştırmalar yapılmıştır. Bu derleme makalede Femur Başı Avasküler Nekrozunda adjuvan tedavi yöntemleri gözden geçirilecektir.

Adjuvant Treatment In Avascular Necrosis Of Femoral Head

Femur head avascular necrosis appears in a way, manifests itself in the form of self-healing or worsening, and finally, due to the long-term permanent damage appeared, it can lead to a point where serious surgical interventions are inevitable. In the current literature, a number of experimental and clinical studies, which were done with various methods such as; plant extracts, sound waves in the hump, bone morphogenetic protein2 (BMP2), iloprost, hyperbaric oxygen and biphosphonates, or cocktail treatment with a mixture of them, are possible to see.  In this review article, adjuvant treatment modalities of Avascular Necrosis Of Femoral Head will be reviewed.

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  • 1. Narayanan A, Khanchandani P, M. Borkar R, Ambati CR, et al. Avascular Necrosis of FemoralHead: A Metabolic, Biophysical, Biochemical, Electron Microscopic and Histopathological Characterization. Sci Rep. 2017; 7: 10721.
  • 2. Okazaki S, Nagoya S, Tateda K, Katada R, Mizuo K, Watanabe S, et al. Weight bearing does not contribute to the development of osteonecrosis of the femoral head. Int J ExpPathol. 2012 Dec; 93(6): 458–462.
  • 3. Wu J, Yao L, Wang B et al. Decoctionameliorates steroid-induced avascular necrosis of the femoral head by regulating the HIF-1α pathway and cell apoptosis. Bio Science Trends 2016; 10(5):410-417.
  • 4. Zhu H, Cai X, Lin T, Shi Z, Yan S. Low-intensity pulsed ultrasound enhances bone repair in a rabbit model of steroid-associated osteonecrosis. Clin Orthop Relat Res 2015 May;473(5):1830-9.
  • 5. Wang CJ, Cheng JH, Huang CC, Yip HK, Russo S. Extracorporeal shockwave therapy for avascular necrosis of femoral head. Int Surg 2015 Dec;24(PtB):184-7.
  • 6. Kim HK, Aruwajoye O, Du J, Kamiya N. Local administration of bone morphogenetic protein-2 and bisphosphonate during non-weight-bearing treatment of ischemic osteonecrosis of the femoral head: an experimental investigation in immature pigs. J Bone Joint Surg Am. 2014 Sep 17;96(18):1515-24.
  • 7. Jäger M, Zilkens C, Bittersohl B, Matheney T, Kozina G, Blondin D et al, Efficiency of iloprost treatmentforosseousmalperfusion. IntOrthop. 2011 May;35(5):761-5.
  • 8. Claßen T, Becker A, Landgraeber S, Haversath M, Li X, Zilkens C et al, Long-term Clinical Results after Iloprost Treatment for Bone Marrow Edema and Avascular Necrosis. Orthop Rev (Pavia). 2016 Mar 31;8(1):6150.
  • 9. Koren L, Ginesin E, Melamed Y, Norman D, Levin D, Peled E. Hyperbaricoxygen for stage I and II femoral head osteonecrosis.Orthopedics. 2015 Mar;38(3):e200-5.
  • 10. Lee YK, Ha YC, Cho YJ, Suh KT, Kim SY, Won YY, et al. Does Zoledronate Prevent Femoral Head Collapse from Osteonecrosis? A Prospective, Randomized, Open-Label, MulticenterStudy. J Bone JointSurgAm. 2015 Jul 15;97(14):1142-8.
  • 11. Roth A, Beckmann J, Bohndorf K, Fischer A, Heiß C, Kenn W,et al, S3-Guideline non-traumatic adult femoral head necrosis. ArchOrthopTraumaSurg. 2016 Feb;136(2):165-74.