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Treatment of transient bone marrow oedema of the hip—a comparative study

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Abstract

Between 1990 and 2000, we treated 43 patients with transient bone marrow oedema of the hip. Five were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and limited weight bearing, and 38 by core decompression followed by limited weight bearing. At follow-up 2–10 years later, all patients were assessed by a structured interview as well as the Harris hip score (HHS) and the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC). Both groups reached the same clinical outcome (HHS and WOMAC). Core decompression enabled a significantly faster recovery. There were no complications, but progression to avascular necrosis was seen in both groups. Core decompression induced fast pain relief, making it the preferable treatment.

Résumé

Entre 1990 et 2000, nous avons traité 43 malades avec un oedème transitoire de la moelle osseuse de la hanche. Cinq ont été traités avec des drogues anti-inflammatoires (AINS) et appui partiel et 38 par forage chirurgical suivi d'un appui partiel. Àu suivi de 2 à 10 ans, tous les malades ont été étudiés par le biais d'une entrevue structurée notant le score de Harris score (HHS) et l'Index d'ostéoarthrose de l'Universités Ontario de l'Ouest (WOMAC). Les deux groupes sont arrivés au même résultat clinique (HHS et WOMAC). Le forage chirurgical a permis une récupération nettement plus rapide. Il n'y avait pas de complications, mais la l'évolution vers la nécrose avasculaire a été vue dans les deux groupes. Le forage chirurgical a induit un soulagement rapide de la douleur, ce qui en fait le traitement préférenciel.

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References

  1. Arlet J (1992) Nontraumatic avascular necrosis of the femoral head. Past, present, and future. Clin Orthop 277:12–21

    PubMed  Google Scholar 

  2. Bellamy N (2002) WOMAC: A 20-year experiential review of a patient-centered self- reported health status questionnaire. J Rheumatol 2912:2473–2476

    Google Scholar 

  3. Bramlett KW, Killian JT, Nasca RJ, Daniel WW (1987) Transient osteoporosis. Clin Orthop 222:197–202

    Google Scholar 

  4. Calvo E, Fernandez-Yruegas D, Alvarez L (2000) Core decompression shortens the duration of pain in bone marrow oedema syndrome. Int Orthop 24:88–91

    Article  CAS  PubMed  Google Scholar 

  5. Curtiss PH (1959) Transitory demineralization of the hip in pregnancy: a report of three cases. J Bone Joint Surg [Am] 41 1:1327–1333

    Google Scholar 

  6. Daniel WW, Sanders PC, Alarcón GS (1992) The early diagnosis of transient osteoporosis by magnetic resonance imaging. A case report. J Bone Joint Surg [Am] 74:1262–1264

    Google Scholar 

  7. Doury P (1994) Bone-marrow oedema, transient osteoporosis, and algodystrophy. J Bone Joint Surg [Br] 76:993–994

    Google Scholar 

  8. Duncan H (1967) Migratory osteolysis of the lower extremities. Ann Intern Med 66:1165–1173

    CAS  PubMed  Google Scholar 

  9. Dunstan CR, Evans RA, Somers NM (1992) Bone death in transient regional osteoporosis. Bone 13:161–165

    CAS  PubMed  Google Scholar 

  10. Grimm J, Higer HP, Heine J (1990) Diagnosis of transitory osteoporosis of the hip and its imaging in magnetic resonance tomography. Z Orthop 128:6–15

    CAS  PubMed  Google Scholar 

  11. Guerra JJ, Steinberg ME (1995) Distinguishing transient osteoporosis from avascular necrosis of the hip. J Bone Joint Surg [Am] 77:616–624

    Google Scholar 

  12. Higer HP, Grimm J, Pedrosa P, Apel R, Bandilla K (1989) Transient osteoporosis or femur head necrosis? Early diagnosis using MRT. ROFO Fortschr Geb Rontgenstr Nuklearmed 150:407–412

    CAS  PubMed  Google Scholar 

  13. Hofmann S, Engel A, Neuhold A, Leder K, Kramer J, Plenk HJ (1993) Bone-marrow oedema syndrome and transient osteoporosis of the hip. An MRI-controlled study of treatment by core decompression. J.Bone Joint Surg [Br] 75:210–216

    Google Scholar 

  14. Hofmann S, Schneider W, Breitenseher M, Urban M, Plenk HJ (2000) "Transient osteoporosis" as a special reversible form of femur head necrosis. Orthopade 29:411–419

    Article  CAS  PubMed  Google Scholar 

  15. Hunder GG, Kelly PJ (1968) Roentgenologic transient osteoporosis of the hip. A clinical syndrome? Ann Intern Med 68:539–552

    PubMed  Google Scholar 

  16. Jiang CC, Shih TT (1994) Epiphyseal scar of the femoral head: risk factor of osteonecrosis. Radiology 191:409–412

    CAS  PubMed  Google Scholar 

  17. Keys GW, Walters J (1987) Idiopathic transient osteoporosis of the hip: brief report. J Bone Joint Surg [Br] 69:773–774

    Google Scholar 

  18. Krause R, Glas K, Schulz A, Gradinger R (2002) The transitory bone marrow edema syndrome of the hip. Z Orthop 140:286–296

    Article  CAS  PubMed  Google Scholar 

  19. Lakhanpal S, Ginsburg WW, Luthra HS, Hunder GG (1987) Transient regional osteoporosis. A study of 56 cases and review of the literature. Ann Intern Med 106:444–450

    PubMed  Google Scholar 

  20. Lakhanpal S, Ginsburg WW, Luthra HS, Hunder GG (1987) Transient regional osteoporosis. A study of 56 cases and review of the literature. Ann Intern Med 106:444–450

    PubMed  Google Scholar 

  21. Langloh ND, Hunder GG, Riggs BL, Kelly JP (1973) Transient painful osteoporosis of the lower extremities. J Bone Joint Surg [Am] 556:1188–1196

    Google Scholar 

  22. Lequesne M (1968) Transient osteoporosis of the hip. A nontraumatic variety of Südeck's atrophy. Ann Rheum Dis 275:463–471

    Google Scholar 

  23. Miyanishi K, Yamamoto T, Nakashima Y, Shuto T, Jingushi S, Noguchi Y, Iwamoto Y (2001) Subchondral changes in transient osteoporosis of the hip. Skeletal Radiol 30:255–261

    Article  CAS  PubMed  Google Scholar 

  24. O'Mara RE (1970) Bone scanning in regional migratory osteoporosis. Radiology 97:579–581

    PubMed  Google Scholar 

  25. Perka C, Buttgereit F, Backhaus M (1998) Pregnancy-induced algodystrophy. Z Rheumatol 57:399–408

    Article  CAS  PubMed  Google Scholar 

  26. Plenk HJ, Hofmann S, Eschberger J, Gstettner M, Kramer J, Schneider W, Engel A (1997) Histomorphology and bone morphometry of the bone marrow edema syndrome of the hip. Clin Orthop 334:73–84

    PubMed  Google Scholar 

  27. Rader CP, Gomille T, Eggert DM, Hendrich C, Eulert J (1997) Results of hip joint boring in femur head necrosis in the adult—4 to 18 years follow-up. Z Orthop 135:494–498

    CAS  PubMed  Google Scholar 

  28. Radke S, Rader CP, Kenn W, Kirschner S, Eulert J (2001) Transient Bone marrow oedema syndrome of the hip—Is core decompression the treatment of choice? J Bone Joint Surg [Br] 83 (Supp II):251252

    Google Scholar 

  29. Rosen RA (1970) Transitory demineralization of the femoral head. Radiology 94:509–512

    CAS  PubMed  Google Scholar 

  30. Shifrin LZ, Reis ND, Zinman H, Besser MI (1987) Idiopathic transient osteoporosis of the hip. J Bone Joint Surg [Br] 69:769–773

    Google Scholar 

  31. Wilson AJ, Murphy WA, Hardy DC, Totty WG (1988) Transient osteoporosis: transient bone marrow edema? Radiology 167:757–760

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Koenig-Ludwig Haus, Julius-Maximilians University Würzburg, Brettreichstr. 11, 97070, Wuerzburg, Germany

    S. Radke, S. Kirschner, V. Seipel, C. Rader & J. Eulert

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  1. S. Radke
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  2. S. Kirschner
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  3. V. Seipel
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  4. C. Rader
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  5. J. Eulert
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Correspondence to S. Radke.

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Radke, S., Kirschner, S., Seipel, V. et al. Treatment of transient bone marrow oedema of the hip—a comparative study. International Orthopaedics (SICOT) 27, 149–152 (2003). https://doi.org/10.1007/s00264-003-0452-y

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  • DOI: https://doi.org/10.1007/s00264-003-0452-y

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