Osteonecrosis after allogeneic bone marrow transplantation

Clinical Orthopaedics and Related Research
Frederic ZadeganL Sedel

Abstract

Osteonecrosis after bone marrow transplantation is usually severe. Most patients develop acute and chronic graft-versus-host disease requiring a high dose of steroids for a long period of time. Generally ineffective nonoperative treatment in the past has resulted in treatment primarily with total hip arthroplasty (THA). We asked whether THA (1) reliably improved functional status, (2) led to more complications, and (3) THA after bone marrow transplantation was as durable as THA for idiopathic ON. We retrospectively reviewed 77 patients (123 hips) with osteonecrosis. The mean age at surgery was 33 years (range, 15.7-56 years). We performed all arthroplasties with an alumina ceramic bearing coupled with an alumina head 32 mm in diameter. The minimum followup was 2 years (mean, 9.2 years; range, 2-26 years). We documented seven revisions: three for late septic loosening, four for late aseptic loosening. Considering loosening of any component as the end point, the survivorship was 74.8% (range, 58.7%-90.9%) at 10 years. In this difficult situation, we believe the results acceptable. Septic loosening affecting this specific population has to be considered a serious event. Level IV, therapeutic study. See the Guidelines for Authors f...Continue Reading

References

May 11, 1992·The Journal of Bone and Joint Surgery. British Volume·R L BarrackW H Harris
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Jun 20, 2006·The Journal of Arthroplasty·Christophe NichMoussa Hamadouche
Jun 15, 2007·The Journal of Arthroplasty·William L WalterBernard A Zicat

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Citations

Feb 6, 2013·Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses·Lisa McDonaldNorma Cuellar
May 22, 2010·Current Pain and Headache Reports·Deborah A Frieze
Aug 21, 2020·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Danielle A CeninNoelle V Frey
Aug 20, 2016·Clinical Orthopaedics and Related Research·Brian P ChalmersMatthew P Abdel

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