Información del artículo
La osteonecrosis, también conocida como necrosis avascular, se ha asociado a numerosos procesos. Su patogenia y, especialmente, su tratamiento son motivo de controversia. En este artículo se revisan la etiología y la patogenia de la osteonecrosis y sus principales opciones terapéuticas.
Palabras clave:
Osteonecrosis
Necrosis avascular
Necrosis aséptica
Necrosis isquémica
Osteonecrosis, also known as aseptic necrosis, is a pathological process that has been associated with numerous conditions. The pathogenesis of osteonecrosis and especially the treatment both remain an area of controversy. In this article we review the etiology and pathogenesis of osteonecrosis as well as the main therapeutic options.
Key words:
Osteonecrosis
Avascular necrosis
Aseptic necrosis
Ischemic necrosis
El Texto completo está disponible en PDF
Bibliografía
[1.]
H.J. Mankin.
Nontraumatic necrosis of bone (osteonecrosis).
N Engl J Med, 326 (1992), pp. 1473-1479
[2.]
M.A. Mont, D.S. Hungerford.
Current concepts review: nontraumatic avascular necrosis of the femoral head.
J Bone Joint Surg, 77-A (1995), pp. 459-474
[3.]
S. Agarwala, D. Jain, V.R. Joshi, A. Sule.
Efficacy of alendronate, a biphosfonate, in the treatment of AVN of the hip. A prospective open-label study.
Rheumatology, 44 (2005), pp. 352-359
[4.]
Y. Assouline-Dayan, C. Chang, A. Greenspan, Y. Shoenfeld, M.E. Gershwin.
Pathogenesis and natural history of osteonecrosis.
Sem Arthritis Rheum, 32 (2002), pp. 94-124
[5.]
J.D.F. Calder, L. Buttery, P.A. Revell, M. Pearse, J.M. Polak.
Apoptosis – a significant cause of bone cell death in osteonecrosis of the femoral head.
J Bone Joint Surg, 86-B (2004), pp. 1209-1213
[6.]
R.S. Weinstein, S.C. Manolagas.
Apoptosis and osteoporosis.
Am J Med, 108 (2000), pp. 153-164
[7.]
R.S. Weinstein, R.W. Nicholas, S.C. Manolagas.
Apoptosis of osteocytes in glucocorticoid-induced osteonecrosis of the hip.
J Clin Endocrinol Metab, 85 (2000), pp. 2907-2912
[8.]
G. Gu, M. Mulari, Peng, T.A. Hentunene, H.K. Väänänen.
Death of osteocytes turns off the inhibition of osteoclats and triggers local bone resorption.
Biochem Biophys Res Com, 335 (2005), pp. 1095-1101
[9.]
Y.F. Liu, W.M. Chen, Y.F. Lin, R.C. Yang, M.W. Lin, L.H. Li, et al.
Type II collagen gene variants and inherited osteonecrosis in the femoral head.
N Engl J Med, 352 (2005), pp. 2294-2301
[10.]
T.M. Zizic, C. Marcoux, D.S. Hungerford, J.V. Dansereau, M.B. Stevens.
Corticosteroid therapy associated with ischemic necrosis of bone in systemic lupus erythematosus.
Am J Med, 79 (1985), pp. 596-604
[11.]
J.R. Lieberman, A.A. Scaduto, E. Wellmeyer.
Symptomatic osteonecrosis of the hip after orthotopic liver transplantation.
J Arthroplasty, 15 (2000), pp. 767-771
[12.]
J. Taillandier, M. Alemanni, D. Samuel, H. Bismuth.
Rheumatic complications following liver transplantation.
Transplant Proc, 31 (1999), pp. 1717-1718
[13.]
G. Bradbury, J. Benjamin, J. Thompson, E. Klees, J. Copeland.
Avascular necrosis of bone after cardiac transplantation. Prevalence and relationship to administration and dosage of steroids.
J Bone Joint Surg, 76-A (1994), pp. 1385-1388
[14.]
O.D. Schoch, R. Speich, C. Schmid, O. Tschopp, E.W. Russi, W. Weder, et al.
Osteonecrosis after lung transplantation: cystic fibrosis as a potential risk factor.
Transplantation, 69 (2000), pp. 1629-1632
[15.]
S.B. Marston, K. Gillingham, R.F. Bailey, E.Y. Cheng.
Osteonecrosis of the femoral head after solid organ transplantation: a prospective study.
J Bone Joint Surg, 84-A (2002), pp. 2145-2151
[16.]
D. Nehme, E. Rondeau, F. Paillard, J.F. Moreau, O. Nussaume, A. Kanfer, et al.
Aseptic necrosis of bone following renal transplantation: Relation with hyperparathyroidism.
Nephrol Dial Transplant, 4 (1989), pp. 123-128
[17.]
L.S. Ibels, A.C. Alfrey, W.E. Huffer, R. Weil 3rd.
Aseptic necrosis of bone following renal transplantation: experience in 194 transplant recipients and review of the literature.
Medicine (Baltimore), 57 (1978), pp. 25-45
[18.]
H.J. Metselaar, E.J. Van Steenberge, A.B. Bijnen, J.J. Jeekel, B. Van Linge, W. Weimar.
Incidence of osteonecrosis after renal transplantation.
Acta Orthop Scand, 56 (1985), pp. 413-415
[19.]
T. Sakai, N. Sugano, Y. Kokado, S. Takahara, K. Ohzono, H. Yoshikawa.
Tacrolimus may be associated with lower osteonecrosis rates after renal transplantation.
Clin Orthop Rel Res, 415 (2003), pp. 163-170
[20.]
J.H. Antin.
Long-term care after hematopoietic-cell transplantation in adults.
N Engl J Med, 347 (2002), pp. 36-42
[21.]
C.M. Schulte, D.W. Beelen.
Avascular osteonecrosis after allogeneic hematopoietic stem-cell transplantation: diagnosis and gender matter.
Transplantation, 78 (2004), pp. 1055-1063
[22.]
L. Tauchmanova, G. De Rosa, B. Serio, F. Fazioli, C. Mainolfi, G. Lombardi, et al.
Avascular necrosis in long-term survivors after allogeneic or autologous stem cell transplantation: a single center experience and review.
Cancer, 97 (2003), pp. 2453-2461
[23.]
C.M. Schulte, D.W. Beelen.
Avascular osteonerosis after allogeneic hematopoietic stem-cell transplantation and gender matter.
Transplantation, 78 (2004), pp. 1055-1063
[24.]
M.A. Mont, C.J. Glueck, I.H. Pacheco, P. Wang, D.S. Hungerford, M. Petri.
Risk factors for osteonecrosis in systemic lupus erythematosus.
J Rheumatol, 24 (1997), pp. 654-662
[25.]
K. Oinuma, Y. Harada, Y. Nawata, K. Takabayashi, I. Abe, K. Kamikawa, et al.
Osteonecrosis in patients with systemic lupus erytematosus develops very early after starting high dose corticosteroid treatment.
Ann Rheum Dis, 60 (2001), pp. 1145-1148
[26.]
M. Abeles, J.D. Urman, N.F. Rotthfield.
Aseptic necrosis of bone in systemic lupus erythematosus. Relatiopnship to corticosteroid therapy.
Arch Intern Med, 138 (1978), pp. 750-754
[27.]
J. Dimant, E.M. Ginzler, H.S. Diamond, M. Schlesinger, C.T. Marino, M. Weiner, et al.
Computer analysis of factors influencing the appearance of aseptic necrosis in patients with SLE.
J Rheumatol, 5 (1978), pp. 136-141
[28.]
N. Sugano, K. Ohzono, K. Mashuara, K. Takaoka, K. Ono.
Prognostication of osteonecrosis of the femoral head in patients with systemic lupus erythematosus by magnetic resonance imaging.
Clin Orthop, 305 (1994), pp. 190-199
[29.]
M.Y. Mok, V.T. Farewell, D.A. Isenberg.
Risk factors for avascular necrosis of bone in patients with systemic lupus erytematous: is there a role for antiphospholipid antibodies?.
Ann Rheum Dis, 59 (2000), pp. 462-467
[30.]
M. Laroche, I. Ludot, M. Thiechart, G. Viguier, C. Dromer, B. Mazieres.
Histological appearance of the intra-osseous vessels of the femoral head in aseptic osteonecrosis of the hip, with or without antiphospholipid antibodies.
Clin Rheumatol, 16 (1997), pp. 367-371
[31.]
S. Migliaresi, U. Picillo, L. Ambrosone, G. Di Palma, M. Mallozzi, E.R. Tesone, et al.
Avascular osteonecrosis in patients with SLE: relation to corticosteroid therapy and anticardiolipin antibodies.
Lupus, 3 (1994), pp. 37-41
[32.]
K. Nagasawa, Y. Ishii, T. Mayumi, Y. Tada, A. Ueda, Y. Yamauchi, et al.
Avascular necrosis of bone in systemic lupus erithematosus: possible role of haemostathic abnormalities.
Ann Rheum Dis, 48 (1989), pp. 672-676
[33.]
C.C. Mok, C.S. Lau, R.W.S. Wong.
Risk factors for avascular necrosis in systemic lupus eritematosus.
Br J Rheumatol, 37 (1998), pp. 895-900
[34.]
R.A. Asherson, F. Liote, B. Page, O. Meyer, N. Buchanan, M.A. Khamashta, et al.
Avascular necrosis of bone and antiphospholipid antibodies in systemic lupus erytematosus.
J Rheumatol, 20 (1993), pp. 284-288
[35.]
M.G. Tektonidou, K. Malagari, P.G. Vlachoyiannopoulos, D.A. Kelekis, H.M. Moutsopoulos.
Assymptomatic vascular necrosis in patients with primary antiphospholipid syndrome in the absence of corticosteroid use: a prospective study by magnetic resonance imaging.
Arthritis Rheum, 48 (2003), pp. 732-736
[36.]
J.S. Lee, K.H. Koo, Y.C. Ha, K.K. Koh, S.J. Kim, H.R. Song, et al.
Role of thrombotic and fibrinolytic disorders in osteonecrosis of the femoral head.
Clin Orthop, 417 (2003), pp. 207-216
[37.]
J.P. Jones.
Epidemiological risk factors for non-traumatic osteonecrosis.
Orthopeade, 29 (2000), pp. 370-379
[38.]
R.M. Egan, R.K. Munn.
Catastrophic antiphospholipid antibody syndrome presenting with multiple thromboses and sites of avascular necrosis.
J Rheumatol, 21 (1994), pp. 2376-2379
[39.]
W.H. Yoo.
Multiple rib infarcts: a rare form of osteonecrosis in antiphospholipid syndrome.
Ann Rheum Dis, 63 (2004), pp. 457-458
[40.]
J. Mundo, P. Peris, A. Monegal, M. Navasa, R. Cervera, N. Guañabens.
Multifocal avascular necrosis after liver transplantation: an unusual presentation of the antiphospholipid síndrome.
Lupus, 15 (2006), pp. 304-307
[41.]
C.G. Zalavras, G. Vartholomatos, E. Dokou, K.N. Malizos.
Factor V Leiden and prothrombin gene mutations in femoral head osteonecrosis.
Thromb Haemost, 87 (2002), pp. 1079-1080
[42.]
V.R. Arruda, W.D. Belangero, M.C. Ozelo, G.B. Oliveira, R.G. Pagnano, J.B. Volpon, et al.
Inherited risk factors for thrombofilia among children with Legg-Calve-Perthes disease.
J Pediatr Orthop, 19 (1999), pp. 84-87
[43.]
L.C. Jones, M.A. Mont, T.B. Le, M. Petri, D.S. Hungerford, P. Wang, et al.
Procoagulants and osteonecrosis.
J Rheumatol, 30 (2003), pp. 783-791
[44.]
K.D. Miller, H. Masur, E.C. Jones, G.O. Joe, M.E. Rick, G.G. Kelly, et al.
High prevalence of osteonecrosis of the femoral head in HIV-infected adults.
Ann Intern Med, 137 (2002), pp. 17-25
[45.]
P. Brown, L. Crane.
Avascular necrosis of bone in patients with human immunodeficiency virus infection: report of 6 cases and review of the literature.
Clin Infect Dis, 32 (2001), pp. 1221-1226
[46.]
M.J. Glebsy, D.R. Hoover, C.M. Vaamonde.
Osteonecrosis in patients infected with human immunodeficiency virus: a case-control study.
J Infect Dis, 184 (2001), pp. 519-523
[47.]
F. Gutiérrez, S. Padilla, E. Ortega, J.A. García, J. Flores, C. Galera, et al.
Avascular necrosis of the bone in HIV-infected patients: incidence and associated factors.
AIDS, 16 (2002), pp. 481-483
[48.]
R.P. Ficat, J. Arlet.
Functional investigation of bone under normal conditions.
Ischemia and necrosis of bone, pp. 29-52
[49.]
J.W. Gardeniers.
A new international classification of osteonecrosis of the ARCO-committee on terminology and classification.
ARCO News, 4 (1992), pp. 41-46
[50.]
M.A. Mont, J.J. Carbone, A.C. Faibank.
Core decompression versus nonoperative management for osteonecrosis of the hip.
Clin Orthop, 324 (1996), pp. 169-178
[51.]
B.N. Stulberg, A.W. Davis, T.W. Bauer, M. Levine, K. Easley.
Osteonecrosis of the femoral head. A prospective randomized treatment protocol.
Clin Orthop Relat Res, 268 (1991), pp. 140-151
[52.]
K.H. Koo, R. Kim, G.H. Ko, H.R. Song, S.T. Jeong, S.H. Cho.
Preventing collapse in early osteonecrosis of the femoral head. A randomised clinical trial of core decompression.
J Bone Joint Surg, 77-B (1995), pp. 870-874
[53.]
F.P. Castro Jr, R.L. Barrack.
Core decompression and conservative treatment for avascular necrosis of the femoral head: a meta-analysis.
Am J Orthop, 29 (2000), pp. 187-194
[54.]
T.R. Yoon, E.K. Song, S.M. Rowe, C.H. Park.
Failure after core decompression in osteonecrosis of the femoral head.
Int Orthop, 24 (2001), pp. 316-318
[55.]
C.J. Lavernia, R.J. Sierra.
Core decompression in atraumatic osteonecrosis of the hip.
J Arthroplasty, 15 (2000), pp. 171-178
[56.]
J.R. Lieberman, A. Conduah, M.R. Urist.
Treatment of osteonecrosis of the femoral head with core decompression and human bone morphogenetic protein.
Clin Orthop Rel Res, 429 (2004), pp. 139-145
[57.]
J.R. Lieberman.
Core decompression for osteonecosis of the hip.
Clin Orthop Rel Res, 418 (2004), pp. 29-33
[58.]
Y. Sugioka, I. Katusi, T. Hotokebuchi.
Transtrocanteric rotational osteotomy of the femoral head for the treatment of osteonecrosis. Follow-up statistics.
Clin Orthop, 169 (1982), pp. 115-126
[59.]
N.D. Marcus, W.F. Enneking, R.A. Massan.
The silent hip in idiopathic aseptic necrosis. Treatment by bone-grafting.
J Bone Joint Surg, 55 A (1973), pp. 1351-1366
[60.]
W.H. Rijnen, J.W. Gardeniers, P. Buma, K. Yamano, T.J. Slooff, B.W. Schreurs.
Treatment of femoral head osteonecrosis using bone impaction grafting.
Clin Orthop Relat Res, 417 (2003), pp. 74-83
[61.]
J.R. Urbaniak, E.J. Harvey.
Revascularization of the femoral head in osteonecrosis.
J An Acad Orthop Surg, 6 (1998), pp. 44-54
[62.]
D. Marciniak, C. Furey, J.W. Shaffer.
Osteonecrosis of the femoral head. A study of 101 hips treated with vascularizated fibular grafting.
J Bone Joint Surg, 87-A (2005), pp. 742-747
[63.]
J.D. Bobin, G.J. Stackpool, S.A. Hacking, M. Tanzer, J.J. Krygier.
Characteristics of bone ingrowth and interface mechanics of bone ingrowth and interface mechanics of new porous tantalum biomaterial.
J Bone Joint Surg, 81-B (1999), pp. 907-914
[64.]
J.D. Bobyn, R.A. Poggie, J.J. Krygier, D.G. Lewallen, A.D. Hanssen, R.J. Lewis, et al.
Clinical validation of structural porous tantalum biomaterial for adult reconstruction.
J Bone Joint Surg, 86-A (2004), pp. 123-129
[65.]
A.K. Tsao, J.R. Roberson, M.J. Christie, D.D. Dore, D.A. Heck, D.D. Robertson, et al.
Biomechanical and clinical evalutions of a porous tantalum implant for the treatment of early-stage osteonecrosis.
J Bone Joint Surg, 87-A (2005), pp. 22-27
[66.]
V. Gangji, J.P. Hauzeur.
Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells.
Bone Joint Surg, 87-A (2005), pp. 106-112
[67.]
B. Mazières.
Osteonecrosis.
Rheumatology, 3.a ed., pp. 1877-1890
[68.]
M. Rizzo, J.R. Urbaniak, et al.
Osteonecrosis.
Kelley's text book of Rheumatology, 7.a ed., pp. 1812-1828
[69.]
C.J. Wang, F.S. Wang, C.C. Huang, K.D. Yang, L.H. Weng, H.Y Huang.
Tretament for osteonecrosis of the femoral head: Comparison of extracorporeal shock waves with core decompression and bone-grafting.
J Bone Joint Surg, 87-A (2005), pp. 2380-2387
[70.]
H. Kim, T.S. Randal, H. Bian, J. Jenkins, A. Garces, F. Bauss.
Ibandronate for prevention of femoral head deformity after ischemic necrosis of the capital femoral epiphysis in immature pigs.
J Bone Joint Surg, 87-A (2005), pp. 550-557
[71.]
D.G. Little, R.A. Peat, A. Mcevoy, P.R. Williams, E.J. Smith, P.A. Baldock.
Zoledronic acid treatment results in retention of femoral head structure after traumatic osteonecrosis in young Wistar rats.
J Bone Miner Res, 18 (2003), pp. 2016-2022
[72.]
L.I. Plotkin, R.S. Weinstein, A.M. Parfitt, P.K. Roberson, S.C. Manolagas, T. Bellido.
Prevention of osteocyte and osteoblast apoptosis by bisphosphonates and calcitonin.
J Clin Invest, 104 (1999), pp. 1363-1374
[73.]
G. Kogianni, V. Mann, F. Ebetino, M. Nuttall, P. Nijweide, H. Simpson, et al.
Fas/CD95 is associated with glucocorticoid-induced osteocyte apoptosis.
Life Sci, 75 (2004), pp. 2879-2895
[74.]
K.A. Lai, W.J. Shen, C.Y. Yang, C.J. Shao, J.T. Hsu, R.M. Lin.
The use of alendronate to prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis.
J Bone Joint Surg, 87-A (2005), pp. 2155-2159
[75.]
S. Saito, M. Saito, T. Nishia, K. Ohzono, K. Ono.
Long-term results of total hip arthroplasty for osteonecrosis of the femoral head. A comparison with osteoarthritis.
Clin Orthop Relat Res, 244 (1989), pp. 198-207
Copyright © 2007. Elsevier España S.L Barcelona
