Orthopaedics and Traumatology, Anadolu Medical Center, Kocaeli, Turkey.
Int Orthop. 2012 Jul;36(7):1523-8. doi: 10.1007/s00264-012-1497-6. Epub 2012 Feb 14.
Pentoxifylline (PTX) is a derivative of methylxanthine and is used in peripheral vascular and cerebrovascular diseases for its effect on the regulation of blood circulation. We investigated whether PTX could be beneficial for femoral head osteonecrosis associated with steroid through these effects.
Sixty mature Leghorn type chickens were chosen and divided into three groups. The 25 chickens in group A were given a weekly dose of 3 mg/kg/week methylprednisolone acetate intramuscularly. Four chickens in group B died after the first drug injection and were excluded from the study. Therefore, the remaining 21 chickens in group B were additionally given 25 mg/kg/day pentoxifylline intramuscularly, along with the steroid medication as given in group A. The ten chickens in group C were not given any injections, as they were accepted as the control group. After the sacrifice of the animals at week 14, both femoral heads were taken from each animal. The animals which died along the course of the study also underwent pathological examination but were not a part of the statistical analysis.
In this study, steroid induced femoral head osteonecrosis has been experimentally observed in chickens after high doses of corticosteroid therapy. The chickens were given pentoxifylline in order to prevent the effects of steroid on bones and bone marrow. The results showed that chickens are suitable osteonecrosis models, and that steroid causes adipogenesis and necrosis in the bone marrow and the death of the subchondral bone.
The results of this study hint at the assumption that PTX may have a positive benefit on ONFH. PTX seems to minimise the effects of the steroid and reduce the incidence of ONFH.
己酮可可碱（PTX）是黄嘌呤衍生物，通过调节血液循环，用于治疗外周血管和脑血管疾病。我们通过这些作用，研究了己酮可可碱是否对因类固醇引起的股骨头坏死有益。
选择 60 只成熟的来亨鸡，分为 3 组。A 组 25 只鸡每周肌肉注射 3mg/kg/周醋酸甲泼尼龙。B 组 4 只鸡在第一次注射后死亡，被排除在研究之外。因此，B 组的其余 21 只鸡除了每周肌肉注射 25mg/kg/天己酮可可碱外，还给予了与 A 组相同的类固醇药物。C 组 10 只鸡未接受任何注射，作为对照组。14 周后动物处死时，从每只动物取双侧股骨头。研究过程中死亡的动物也进行了病理检查，但未纳入统计分析。
本研究在大剂量皮质类固醇治疗后，在鸡中实验性观察到类固醇诱导的股骨头坏死。给鸡注射己酮可可碱以防止类固醇对骨骼和骨髓的影响。结果表明，鸡是合适的骨坏死模型，类固醇可引起骨髓脂肪生成和坏死以及软骨下骨死亡。
本研究结果提示，PTX 可能对 ONFH 有益。PTX 似乎可以减轻类固醇的作用，降低 ONFH 的发生率。
