Objective To investigate diagnosis and surgical management of femoral head osteonecrosis in sickle cell disease(SCD). Methods The related literature available today was reviewed, and the clinical advance in the diagnosis of femoral head osteonecrosis complicating SCD and its surgical management was evaluated. Results Although the advance in the diagnosisand the surgical treatment for the femoral head osteonecrosis in SCD had been achieved, challenging clinical problems still remained because of many complications after the surgical treatment. Whether the surgical management was reasonablein a particular stage of the disease and for a specific patient still required investigation. Conclusion Whether the salvage of the patient’ship joint should be performed or the artificial joint replacement should be performed still needs a cautious consideration before either of the surgical managements is given.
Objective To explore the significance of osteocyte apoptosis in steroidinduced osteonecrosis of the femoral head. Methods SixtyNew Zealand rabbits were divided into experimental group and control group(n=30). The experimental group was given 10 ml/kg of horse serum intravenously 2 times at 2 weeks intervals and an intraperitoneal injection of 45 ml/kg·d of methylprednisolone acetate for 3 days；the control group was given equal isotonic Na chloride. Osteocyteapoptosis was observe by means of TUNEL. Results The number of apoptosis in the experimental group(112.33‰±26.12‰) was significantly higher than that in the control(47.01‰±22.95‰) (Plt;0.01)in the 4th week. With time, osteocytes apoptosis progressively increased. In the 6thand 8th weeks, the percentage of empty osteocyte lacunae in the experimental group (17.23%±3.44%, 28.56%±3.45%) was significantly higher than that in the control group (11.29%±2.89%,11.26%±2.75%，Ｐlt;0.05). The transmission electron microscope showed that the characteristics of osteocyte apoptosisincluded intact nuclear membrane,comdensed chromatin and increased electron dense. Conclusion Osteocytes apoptosis may play a key role in the process of steroidinduced early osteonecrosis of the femoral head.