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Procoagulants and osteonecrosis
Lynne C Jones1, Michael A Mont, Tung B Le
1Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21239, USA. lcjones@jhmi.edu
The Journal of Rheumatology
|April 3, 2003
Summary
Osteonecrosis patients frequently exhibit thrombophilic and hypofibrinolytic coagulation abnormalities. Identifying these blood clotting disorders may aid in early detection and treatment strategies for osteonecrosis.
Area of Science:
- Hematology
- Orthopedics
- Vascular Biology
Background:
- Osteonecrosis is a debilitating condition often linked to vascular compromise.
- Thrombophilia and hypofibrinolysis are implicated in thrombotic events, but their direct role in osteonecrosis requires further elucidation.
Purpose of the Study:
- To investigate the prevalence of thrombophilic and hypofibrinolytic coagulation abnormalities in patients diagnosed with osteonecrosis.
- To determine the association between specific coagulation factor concentrations and the occurrence of osteonecrosis.
Main Methods:
- Analyzed blood samples from 45 osteonecrosis patients and 40 healthy controls.
- Assessed levels of plasminogen activator inhibitor (PAI-Fx), lipoprotein (a), anticardiolipin antibodies (aCL IgG, IgM), and other coagulation factors.
- Correlated findings with known osteonecrosis risk factors such as systemic lupus erythematosus and corticosteroid therapy.
Main Results:
- 82.2% of osteonecrosis patients showed at least one coagulopathy, compared to 30% of controls (p < 0.0001).
- 46.7% of patients had two or more abnormalities, versus 2.5% in controls (p < 0.0001).
- Elevated plasminogen activator inhibitor activity (42% vs 3%) and anticardiolipin antibody IgG (34% vs 10%) were significantly higher in patients.
Conclusions:
- A high incidence of thrombophilic and hypofibrinolytic coagulation abnormalities exists in osteonecrosis patients.
- These findings suggest potential diagnostic and therapeutic implications for managing osteonecrosis.
- Identifying at-risk individuals may be possible through screening for these inherited coagulation disorders.