Firooz Madadi, MD; Seyed Morteza Kazemi, MD; Armin Aalami Harandi, MD; Mohammad Reza Abbassian, MD; Farivar Abdollahzadeh Lahiji, MD; Hamid Hossienzadeh, MD; Fooad Rahimi, MD
Abstract
Background: Avascular necrosis (AVN) of femoral head, with resultant joint destruction, is a common disabling disease of fourth and fifth decades of life. Metal-on-metal resurfacing is a relatively newer treatment modality for this disease. The aim of this study is to compare the result of resurfacing ...
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Background: Avascular necrosis (AVN) of femoral head, with resultant joint destruction, is a common disabling disease of fourth and fifth decades of life. Metal-on-metal resurfacing is a relatively newer treatment modality for this disease. The aim of this study is to compare the result of resurfacing for osteonecrosis with that of resurfacing for other causes.Methods: Twenty eight patients with stage III or IV (Ficat & Arlet) osteonecrosis who underwent metal-on- metal hip resurfacing were compared with 24 cases of grade IV or V (Croft’s) osteoarthritis (OA) who had undergone the same kind of arthroplasty during a 2 year period in Akhtar hospital in Tehran. These cases were matched in terms of gender and age, and were assessed by Harris hip score with 41(±22) months follow-up.Results: The AVN cases had 30.86 (±7.5) and OA cases 47.88 (±12.6) years at surgery. Three patients from each of the above groups had sustained complications of either femoral neck or acetabular cup fracture and had required revision surgery. The average Harris hip score was 94(±7.2) in AVN and 91.2(±9.4) in OA group. The collective hip range of motion was 216(±6.2) in AVN and 196±(5.6) in AO patients.Conclusions: Metal-on-metal hip resurfacing gives similar satisfactory results in avascular necrosis and in osteoarthritis of hip joint in short-term, with no statistically significant difference.
Seyed Morteza Kazemi, MD; Hamidreza Hosseinzadeh, MD; Armin Aalami Harandi, MD; Faraz Ranjpour, MD Ranjpour, MD
Abstract
Methods: In a case series study, cases of osteonecrosis in Akhtar hospital in Tehran with history of temgesic and norgesic abuse were identified in a 2 year period. The hospital charts of 11 cases with such characteristics were evaluated.Results: Eleven cases with mean age of 37.72±5.55 years comprised ...
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Methods: In a case series study, cases of osteonecrosis in Akhtar hospital in Tehran with history of temgesic and norgesic abuse were identified in a 2 year period. The hospital charts of 11 cases with such characteristics were evaluated.Results: Eleven cases with mean age of 37.72±5.55 years comprised the study group. Five cases had used norgesic, 5 temgesic and 1 patient had used both of those agents. The average drug dosage was 4.36±2.29 vials per day for an average of 4.9±2.9 months. Onset of symptoms was 11.36±2.76 months after drug usage on average. Three cases had skin stria and 7 patients had localized obesity, both suggesting steroid effect. Bilateral involvement of bone ends was observed in all, while 3 cases had more than two joints affected.Conclusions: Norgesic and temgesic cause osteonecrosis with severe joint destruction. Raising the awareness of general public and physicians towards such a devastating complication is warranted.
