Abstract

Although core decompression (CD) is often performed in the early stages of osteonecrosis of the femoral head (ONFH), the procedure does not always prevent subsequent deterioration and the effects of CD are not fully clarified.The aim of this study was to evaluate the efficacy of CD for steroid associated ONFH in rabbits.Twelve male and twelve female New Zealand rabbits were injected intramuscularly 20 mg/kg of methylprednisolone once and were divided into the disease control and CD groups. In the disease control group, rabbits had no treatment and were euthanized at 12 weeks post-injection. In the CD group, rabbits underwent left femoral CD at 4 weeks post-injection and were euthanized 8 weeks postoperatively. The left femurs were collected to perform morphological, biomechanical and histological analysis.Bone mineral density and bone volume fraction in the femoral head in the CD group were significantly higher than in the disease control group. However, no difference in the mechanical strength was observed between the two groups. Histological analysis showed thatalkaline phosphatase and CD31 positive cells significantly increased in the males after CD treatment. The number of empty lacunae in the surrounding trabecular bone was significantly higher in the CD group.The current study indicated that CD improved the morphological properties, but did not improve the mechanical strength in the femoral headat early stage ONFH.These data suggest the need for additional biological, mechanical strategies,and therapeutic windows to improve the outcome of early stage steroid associated ONFH. This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/jor.24888

View details for PubMedID 33095462