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      Comparison of Total Hip Arthroplasty and Core Decompression in Avascular Necrosis of the Femoral Head after Taking Temgesic and Norgesic

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          Abstract

          Background

          Osteonecrosis is common after taking Temgesic and Norgesic. This study intended to suggest the preferable surgical treatment in osteonecrosis patients who use these drugs.

          Methods

          Twenty tree patients with hip osteonecrosis who were hospitalized in the Kerman hospitals after using Temgesic and Norgesic were followed for about 14 months from 2008 to 2010 (from a minimum of 2 months to a maximum of 2 years). 65% of patients underwent total hip arthroplasty (THA) and core decompression was performed for 35% of them. Patients were compared based on functional scoring of hip before and after surgery.

          Findings

          Duration of drug use was 38 months on average and injection frequency of drug was averagely 3 months. The average functional scoring of hip was 9.1 before operation and 16 after it (P < 0.001). Recovery rate of patients in THA was very good and in core decompression was good.

          Conclusion

          In treatment of osteonecrosis after taking Temgesic and Norgesic, the THA surgery in comparison with core decompression showed better results and caused significant clinical improvement.

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          Most cited references13

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          Functional results of hip arthroplasty with acrylic prosthesis.

          M. Postel, R. d’Aubigné (1954)
          Article 0 comments Cited 111 times – based on 0 reviews     Review now
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            Risk period for developing osteonecrosis of the femoral head in patients on steroid treatment.

            Joo Yeon Song, I O Ahn, Peter K. Koo … (2002)
            Patients who require long-term steroid use are at risk for the development of osteonecrosis. However, the risk period for developing osteonecrosis of the femoral head has not yet been defined. The authors attempted to determine the onset of osteonecrosis of the femoral head following steroid treatment. Medical record data of patients with steroid-related osteonecrosis of the femoral head from four university hospitals were reviewed. Information was collected regarding the duration and dose of steroid use for patients who were diagnosed at the early stage by magnetic resonance imaging (MRI) without positive findings on plain radiographs (Association Research Circulation Osseous stage I osteonecrosis). Twenty-two patients were diagnosed at Association Research Circulation Osseous stage I. There were eight male and 14 female patients ranging in age from 17 to 60 years (mean 33). The total dose of steroid, which was used until the time of detection of osteonecrosis by MRI, ranged from 1800 to 15 505 mg prednisolone or its equivalent (mean 5928 mg). The period from the start of steroid treatment to the diagnosis by MRI ranged from 1 month to 16 months (mean 5.3 months). Twenty-one of 22 patients were diagnosed within 12 months of the initiation of steroid treatment. The duration of steroid treatment within this period ranged from 1 month to 12 months (mean 4.5 months). There may be a risk period of 12 months for developing femoral head osteonecrosis in patients receiving long-term steroid treatment. Close observation and more aggressive screening are recommended within the first year of long-term steroid treatment to prevent advanced osteonecrosis of the femoral head.
            Article 0 comments Cited 57 times – based on 0 reviews     Review now
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              Osteonecrosis in patients with systemic lupus erythematosus develops very early after starting high dose corticosteroid treatment.

              Y Nawata, K. Oinuma, Y. Harada … (2001)
              To investigate the actual time of onset of osteonecrosis (ON) after high dose corticosteroid treatment in systemic lupus erythematosus (SLE). 72 patients with active SLE, who received high dose corticosteroid for the first time, for the development of ON at hips and knees were monitored by magnetic resonance imaging for at least 12 months. ON lesions were detected in 32/72 patients (44%) between one and five months (3.1 months on average) after starting high dose corticosteroid treatment. No osteonecrotic lesion was newly detected from the sixth month of treatment until the end of the follow up period. The findings suggested that the actual time of onset of ON in SLE is within the first month of high dose corticosteroid treatment.
              Article 0 comments Cited 45 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Addict Health
                Journal ID (iso-abbrev): Addict Health
                Journal ID (publisher-id): AHJ
                Title: Addiction & Health
                Publisher: Kerman University of Medical Sciences
                ISSN (Print): 2008-4633
                ISSN (Electronic): 2008-8469
                Publication date (Print): Summer-Autumn 2012
                Volume: 4
                Issue: 3-4
                Pages: 117-121
                Affiliations
                [1 ]Associate Professor, Department of Orthopedic Surgery, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
                [2 ]Resident, Department of Orthopedic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [3 ]Psychiatrist, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
                [4 ]Associate Professor, Department of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
                Author notes
                Correspondence to: Ali Kheradmand MD, Email: dr.alikheradmand@ 123456yahoo.com
                Article
                Publisher ID: AHJ-04-117
                PMC ID: 3905541
                SO-VID: 8cbac7b6-3136-4632-8742-0aad7a14654c
                Copyright © © 2013 Kerman University of Medical Sciences
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Date received : 15 March 2012
                Date accepted : 06 June 2012
                Categories
                Subject: Original Article

                Keywords: total hip arthroplasty,core decompression,avascular necrosis,temgesic,norgesic
                Data availability:
                Keywords: total hip arthroplasty, core decompression, avascular necrosis, temgesic, norgesic

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