A Comparison of Transphyseal Neck-Head Tunneling and Multiple Epiphyseal Drilling on Femoral Head Healing Following Ischemic Osteonecrosis: An Experimental Investigation in Immature Pigs

Journal of Pediatric Orthopedics
Olumide AruwajoyeHarry Kim

Abstract

Two operative procedures are currently advocated to stimulate the necrotic femoral head healing in children with Legg-Calve-Perthes disease: transphyseal neck-head tunneling (TNHT) and multiple epiphyseal drilling (MED). The purpose of this study was to compare the bone healing and physeal function after treatment with TNHT or MED in a piglet model of ischemic osteonecrosis. Eighteen piglets were induced with osteonecrosis by surgically placing a ligature tightly around the right femoral neck. One week later, the piglets were assigned to 1 of 3 treatment groups (n=6/group): (1) local nonweight bearing only (NWB), (2) TNHT plus NWB, or (3) MED plus NWB. The unoperated left femoral heads were used as normal controls. The animals were euthanized at 8 weeks after osteonecrosis induction. Histologic, histomorphometric, radiographic, microcomputed tomography (CT), and calcein-labeling assessments were performed. Statistical analysis included a 1-way ANOVA. Micro-CT analyses showed higher femoral head bone volume in the MED group compared with the TNHT and the NWB groups (P<0.01). The MED group had a higher mean trabecular number (P<0.001) and new bone formation (P=0.001) based on calcein-labeling parameters compared with the TNHT and...Continue Reading

References

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Citations

Apr 13, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·William Z MorrisHarry Kw Kim
Dec 29, 2020·The Journal of Bone and Joint Surgery. American Volume·Lindsay M Andras, Oussama Abousamra
Oct 15, 2020·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Yinshi RenHarry Kw Kim

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Methods Mentioned

BETA
amputation

Software Mentioned

OSTEOIMAGER
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BIOQUANT Image Analysis
CTAn
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