Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head

Nontraumatic osteonecrosis of the femoral head is still a challenging problem in orthopedic surgery. It is responsible for 10% of the 500,000 hip replacement surgeries in the USA and affects relatively young, active patients in particular. Main reasons for nontraumatic osteonecrosis are glucocortico...

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Main Authors:	Beckmann, Rainer, Shaheen, Hayfaa, Kweider, Nisreen, Ghassemi, Alireza, Fragoulis, Athanassios, Hermanns-Sachweh, Benita, Pufe, Thomas, Kadyrov, Mamed, Drescher, Wolf
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106066/

id	pubmed-4106066
recordtype	oai_dc
spelling	pubmed-41060662014-08-10 Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head Beckmann, Rainer Shaheen, Hayfaa Kweider, Nisreen Ghassemi, Alireza Fragoulis, Athanassios Hermanns-Sachweh, Benita Pufe, Thomas Kadyrov, Mamed Drescher, Wolf Research Article Nontraumatic osteonecrosis of the femoral head is still a challenging problem in orthopedic surgery. It is responsible for 10% of the 500,000 hip replacement surgeries in the USA and affects relatively young, active patients in particular. Main reasons for nontraumatic osteonecrosis are glucocorticoid use, alcoholism, thrombophilia, and hypofibrinolysis (Glueck et al., 1997; Orth and Anagnostakos, 2013). One pathomechanism of steroid-induced osteonecrosis is thought to be impaired blood flow to the femoral head caused by increased thrombus formation and vasoconstriction. To investigate the preventive effect of enoxaparin on steroid-related osteonecrosis, we used male New Zealand white rabbits. Osteonecrosis was induced by methylprednisolone-injection (1 × 20 mg/kg body weight). Control animals were treated with phosphate-buffered saline. Treatment consisted of an injection of 11.7 mg/kg body weight of enoxaparin per day (Clexane) in addition to methylprednisolone. Four weeks after methylprednisolone-injection the animals were sacrificed. Histology (hematoxylin-eosin and Ladewig staining) was performed, and empty lacunae and histological signs of osteonecrosis were quantified. Histomorphometry revealed a significant increase in empty lacunae and necrotic changed osteocytes in glucocorticoid-treated animals as compared with the glucocorticoid- and Clexane-treated animals and with the control group. No significant difference was detected between the glucocorticoid and Clexane group and the control group. This finding suggests that cotreatment with enoxaparin has the potential to prevent steroid-associated osteonecrosis. Hindawi Publishing Corporation 2014 2014-07-02 /pmc/articles/PMC4106066/ /pubmed/25110730 http://dx.doi.org/10.1155/2014/347813 Text en Copyright © 2014 Rainer Beckmann et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Beckmann, Rainer Shaheen, Hayfaa Kweider, Nisreen Ghassemi, Alireza Fragoulis, Athanassios Hermanns-Sachweh, Benita Pufe, Thomas Kadyrov, Mamed Drescher, Wolf
spellingShingle	Beckmann, Rainer Shaheen, Hayfaa Kweider, Nisreen Ghassemi, Alireza Fragoulis, Athanassios Hermanns-Sachweh, Benita Pufe, Thomas Kadyrov, Mamed Drescher, Wolf Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head
author_facet	Beckmann, Rainer Shaheen, Hayfaa Kweider, Nisreen Ghassemi, Alireza Fragoulis, Athanassios Hermanns-Sachweh, Benita Pufe, Thomas Kadyrov, Mamed Drescher, Wolf
author_sort	Beckmann, Rainer
title	Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head
title_short	Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head
title_full	Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head
title_fullStr	Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head
title_full_unstemmed	Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head
title_sort	enoxaparin prevents steroid-related avascular necrosis of the femoral head
description	Nontraumatic osteonecrosis of the femoral head is still a challenging problem in orthopedic surgery. It is responsible for 10% of the 500,000 hip replacement surgeries in the USA and affects relatively young, active patients in particular. Main reasons for nontraumatic osteonecrosis are glucocorticoid use, alcoholism, thrombophilia, and hypofibrinolysis (Glueck et al., 1997; Orth and Anagnostakos, 2013). One pathomechanism of steroid-induced osteonecrosis is thought to be impaired blood flow to the femoral head caused by increased thrombus formation and vasoconstriction. To investigate the preventive effect of enoxaparin on steroid-related osteonecrosis, we used male New Zealand white rabbits. Osteonecrosis was induced by methylprednisolone-injection (1 × 20 mg/kg body weight). Control animals were treated with phosphate-buffered saline. Treatment consisted of an injection of 11.7 mg/kg body weight of enoxaparin per day (Clexane) in addition to methylprednisolone. Four weeks after methylprednisolone-injection the animals were sacrificed. Histology (hematoxylin-eosin and Ladewig staining) was performed, and empty lacunae and histological signs of osteonecrosis were quantified. Histomorphometry revealed a significant increase in empty lacunae and necrotic changed osteocytes in glucocorticoid-treated animals as compared with the glucocorticoid- and Clexane-treated animals and with the control group. No significant difference was detected between the glucocorticoid and Clexane group and the control group. This finding suggests that cotreatment with enoxaparin has the potential to prevent steroid-associated osteonecrosis.
publisher	Hindawi Publishing Corporation
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106066/
_version_	1613116461656571904

Enoxaparin Prevents Steroid-Related Avascular Necrosis of the Femoral Head

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