Roth Andreas, Maus Uwe
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Bereich Endoprothetik/Orthopädie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, Haus 4, 04103, Leipzig, Deutschland.
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
Orthopadie (Heidelb). 2022 Oct;51(10):783-791. doi: 10.1007/s00132-022-04300-2. Epub 2022 Sep 8.
The medicinal treatment of osteonecrosis is described as part of the conservative treatment for atraumatic femoral head necrosis of the hip in adults and for Ahlbäck's disease of the knee joint. For femoral head necrosis, iloprost is used in the early stages (ARCO I and II) as a treatment attempt to eliminate pain and the accompanying bone marrow edema. This also applies to the use of bisphosphonates, whereby preferably small defects (< 30%) are suitable for treatment. Bisphosphonates are successfully used in the knee joint to treat Ahlbäck's disease, although the results are sometimes contradictory. Other locations, such as the humeral head, talus, scaphoid, lunate, proximal tibia, and metatarsal head, are sometimes successfully treated with bisphosphonates. Although the results seem promising, the groups are far too small to derive treatment recommendations in this regard.
骨坏死的药物治疗被描述为成人非创伤性股骨头坏死和膝关节阿尔贝克病保守治疗的一部分。对于股骨头坏死，伊洛前列素在早期阶段（ARCO I和II期）用于尝试消除疼痛及伴随的骨髓水肿。双膦酸盐的使用也是如此，最好是小面积缺损（<30%）适合治疗。双膦酸盐已成功用于膝关节治疗阿尔贝克病，尽管结果有时相互矛盾。其他部位，如肱骨头、距骨、舟骨、月骨、胫骨近端和跖骨头，有时也可用双膦酸盐成功治疗。尽管结果似乎很有前景，但相关病例组规模太小，无法就此得出治疗建议。
