Wos Açık Erişimli Yayınlar

Permanent URI for this collectionhttps://hdl.handle.net/11727/10754

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Subject: search.filters.subject.Avascular necrosis

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    Intractable pain following core decompression caused by salmonella septic arthritis
    (2016) Beyaz, Salih; Guler, Umit Ozgr; Cinar, Bekir Murat; Bolat, Filiz Aka; 0000-0002-7906-5039; 0000-0002-5375-635X; 0000-0002-5788-5116; 0000-0002-5788-5116; AAL-4474-2021; O-7590-2017; K-8820-2019; M-2609-2013
    Glucocorticoids (GC), often used in the treatment of diseases caused by autoimmune mechanisms, are the most common nontraumatic causative factor of femoral head avascular necrosis (FHAN). FHAN is, in turn, the most common cause leading to orthopedic surgery in patients using GCs. As GCs suppress the immune system, patients experience increased susceptibility to infections, including FHAN, which has a similar clinical manifestation with septic arthritis. In rare cases, septic arthritis may be caused by salmonella in patients using GCs. Core decompression is the gold standard in the treatment of early stage FHAN. We report a 28-year-old male patient with multiple sclerosis (MS) presenting with the complaints of hip pain. The patient had been treated with two megadoses of steroids. FHAN was considered due to X-ray and MRI findings. The patient underwent core decompression (CD) and salmonella bacteria growth was found in the hip puncture culture. Avascular necrosis associated with septic arthritis was determined. The patient was re-operated and irrigation and debridement for synovial tissues were performed two days following the first operation. While the association of septic arthritis with causative Salmonella and FHAN is rare except in sickle cell patients, septic arthritis must be considered and ruled out in patients who have previously undergone CD and did not show expected relief in early stage FHAN.
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    Outcomes for core decompression with multiple drilling of the osteonecrosis of the femoral head in patients with solid organ transplantation
    (2018) Haberal, Bahtiyar; Sahin, Orcun; Simsek, Ekin Kaya; Mahmuti, Ates; Tuncay, Ismail Cengiz; 30376800
    Objectives: This study aims to investigate the clinical and radiological outcomes of core decompression surgery performed with multiple drilling in solid organ transplantation patients with osteonecrosis of femoral head (ONFH) and evaluate the effectiveness of this procedure in regard to duration of corticosteroid use and stage of osteonecrosis. Patients and methods: A total of 22 solid organ transplantation (kidney, liver or heart) patients (14 males, 8 females; mean age 43.3 years; range. 23 to 67 years) who were scheduled to undergo core decompression surgery with multiple drilling for ONFH were evaluated. Patients' Harris hip scores (HHSs) and radiographic data including Association Research Circulation Osseous (ARCO) staging and Kerboul grading were retrospectively reviewed at pre- and postoperative controls. Results: Patients were followed-up for mean 34.3 months (range, 12 to 76 months). Two patients (9.09%) were performed total hip arthroplasty. These two patients' Kerboul grade was 3. There was no statistically significant relationship between preoperation and postoperative final control in terms of ARCO staging. There was no statistically significant difference between pre- and postoperative HHSs. Conclusion: Although multiple drilling is a safe and minimally invasive surgery, its effect is limited, particularly in solid organ transplantation patients with ONFH due to long-term corticosteroid use. Therefore, solid organ transplantation patients should be closely monitored in terms of ONFH development.