[Revascularization of avascular spongy bone].

Area of Science:

• Orthopedic Surgery
• Vascular Biology
• Regenerative Medicine

Background:

• Aseptic necrosis of the femoral head is a debilitating condition characterized by impaired blood supply.
• Current treatments often focus on symptom management rather than addressing the underlying circulatory deficit.
• Understanding the microcirculatory changes is crucial for developing effective therapeutic strategies.

Purpose of the Study:

• To investigate the effects of revascularization techniques on blood circulation in experimental aseptic necrosis of the canine femoral head.
• To evaluate the impact of specific surgical interventions on intraosseous pressure and hemodynamics.
• To establish a reliable experimental model for studying femoral head osteonecrosis.

Main Methods:

• Simulated aseptic necrosis was induced in 48 canine hip joints.
• Surgical revascularization of the femoral head was performed using the caudal epigastric artery and its accompanying veins in one group.
• A tunneling procedure was performed in a second group, with a third group serving as a control.
• Intraosseous contrast phlebography, arteriography, and microscopic examination of osseous tissue were utilized to assess microcirculation.

Main Results:

• Microcirculation disturbances were confirmed in experimental aseptic necrosis.
• Aseptic necrosis of the femoral head was associated with elevated intraosseous pressure.
• Revascularization of avascular bone led to stable normalization of intraosseous hemodynamics.

Conclusions:

• Revascularization of the avascular femoral head in experimental aseptic necrosis effectively restores normal intraosseous hemodynamics.
• Surgical interventions targeting blood supply can reverse microcirculatory disturbances associated with femoral head osteonecrosis.
• These findings support the potential of revascularization as a therapeutic approach for aseptic necrosis of the femoral head.