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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-02-2012 | Hip

Arthroscopic management and platelet-rich plasma therapy for avascular necrosis of the hip

Authors: Jorge Guadilla, Nicolas Fiz, Isabel Andia, Mikel Sánchez

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2012

Abstract

Purpose

The purpose is to describe a noninvasive arthroscopic procedure as an alternative to open surgery for avascular necrosis of the hip.

Methods

Patients with grade I or IIA avascular necrosis of the hip are treated by core decompression performed by drilling under fluoroscopic guidance. Liquid platelet-rich plasma (PRP) is delivered through a trocar, saturating the necrotic area. In more severe conditions, the necrotic bone is decompressed and debrided, through a cortical window at the head–neck junction. A composite graft made of autologous bone and PRP is delivered by impactation through the core decompression track. Fibrin membranes are applied to enhance healing of the head–neck window and arthroscopic portals. Platelet-rich plasma is infiltrated in the central compartment.

Results

This arthroscopic approach aids in making diagnosis of the labrum and articular cartilage and permits intra-operative treatment decisions. Visual control permits the precise localization and treatment for the necrotic area allowing cartilage integrity to be preserved.

Conclusions

Arthroscopic management of avascular necrosis of the femoral head is viable and has significant advantages. Clinical studies should justify the theoretical additional benefits of this approach.

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Title: Arthroscopic management and platelet-rich plasma therapy for avascular necrosis of the hip
Authors: Jorge Guadilla
Nicolas Fiz
Isabel Andia
Mikel Sánchez
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1587-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Arthroscopic management and platelet-rich plasma therapy for avascular necrosis of the hip

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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