Department of Orthopaedic Surgery, University Hospital of Duesseldorf, Duesseldorf, Germany.
Int Orthop. 2011 May;35(5):761-5. doi: 10.1007/s00264-010-0998-4. Epub 2010 Mar 21.
Insufficient osseous blood supply results in bone marrow oedema (BMO) and/or avascular necrosis (AVN). One treatment option to support osseous perfusion is the application of stable prostacycline analog iloprost. In this clinical study, 95 patients were treated with iloprost for BMO/AVN. One hundred eighty-six bones were affected by BMO/AVN before treatment. Average follow-up was 33.0 ± 17.6 months. Pain levels could be reduced (e.g. visual analogue scale, 5.0 ± 2.2 points reduced to 1.7 ± 2.2 points) and functional scores improved (Harris hip score, 52 ± 21 points to 79 ± 17 points) in the course of treatment. According to current data, healing of advanced stages of osteonecrosis is not possible. However, the results of this case series confirm previous findings that in early stages of insufficient osseous blood flow iloprost can contribute to the relief of pain and improve joint function.
骨血供应不足会导致骨髓水肿(BMO)和/或缺血性坏死(AVN)。一种支持骨质灌注的治疗选择是应用稳定的前列环素类似物伊洛前列素。在这项临床研究中,95 名 BMO/AVN 患者接受了伊洛前列素治疗。治疗前,186 块骨头受到 BMO/AVN 的影响。平均随访时间为 33.0 ± 17.6 个月。在治疗过程中,疼痛程度可降低(例如视觉模拟评分,从 5.0 ± 2.2 分降至 1.7 ± 2.2 分),功能评分可改善(Harris 髋关节评分,从 52 ± 21 分提高至 79 ± 17 分)。根据目前的数据,晚期骨坏死的愈合是不可能的。然而,本病例系列的结果证实了先前的发现,即在骨质血流不足的早期阶段,伊洛前列素可以有助于缓解疼痛和改善关节功能。