Clinical and Radiographic Alterations in Bilateral Avascular Necrosis of the Femoral Head Following Laser Acupuncture: A Case Report
Journal of Lasers in Medical Sciences,
Vol. 9 No. 2 (2018),
27 April 2018
,
Page 149-153
Abstract
Introduction: Avascular necrosis (AVN) of the femoral head is an increasingly common cause of musculoskeletal disability with unknown etiology. Traumatic and non-traumatic factors can be effective in its occurrence. About 50% of cases are bilateral. The underlying treatment is prosthetic replacement surgical procedure.Case Presentation: We report a case of bilateral AVN of femoral heads who was a candidate for prosthetic replacement surgery but improved significantly, using laser acupuncture. The patient was a 55-year-old woman with a diagnosis of bilateral osteonecrosis of the femoral head for five years. As the patient declined the surgical option, laser acupuncture was started for pain control. Regarding the signs of bilateral femoral head recovery (according to the MRI scan criteria), a total of 3 courses of laser acupuncture (each course was 20 sessions) with 2 months intervals was performed. Ten acupuncture points: Li4, Li11, St36, SP6, LIV3, GB4, GB5, GB6, GB13, GB14, GB20, GB30, GB31, GB34, were irradiated bilaterally using red 650 nm laser, 100 mW, 1505 Hz frequency, duty cycle 50 3 J/point and near infrared 810 nm laser, 100 mW, 1705 Hz frequency, duty cycle 50 3 J/point, for 2 minutes. The patient received 3 laser therapy courses. During the first-course, laser therapy was done every other day to reduce pain. For the second and third courses, according to pain decrease, therapy was done every week.
Results: The results of the MRI scans and x-ray studies show progressive regeneration of the right femoral head from VI to B II and of the left from V to C II (based on the standard table of Pennsylvania).
Conclusion: It seems that this procedure may be mentioned in future research projects, especially in cases with high risks of surgery.
- Avascular necrosis
- Femoral head
- Laser acupuncture
- Regenerative medicine.
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References
Wenger D, Samuelsson H, Duppe H, Tiderius CJ. Early treatment with the von Rosen splint for neonatal instability of the hip is safe regarding avascular necrosis of the femoral head: 229 consecutive children observed for 6.5 years. Acta Orthop. 2016;87(2):169-175. doi:10.3109/17453674.2015.1 126158
Daoud AM, Hudson M, Magnus KG, et al. Avascular Necrosis of the Femoral Head After Palliative Radiotherapy in Metastatic Prostate Cancer: Absence of a Dose Threshold? Cureus. 2016;8(3):e521. doi:10.7759/cureus.521
Pepke W, Kasten P, Beckmann NA, Janicki P, Egermann M. Core Decompression and Autologous Bone Marrow Concentrate for Treatment of Femoral Head Osteonecrosis: A Randomized Prospective Study. Orthop Rev (Pavia). 2016;8(1):6162. doi:10.4081/or.2016.6162
Castro FP Jr, Barrack RL. Core decompression and conservative treatment for avascular necrosis of the femoral head: a meta-analysis. Am J Orthop (Belle Mead NJ). 2000;29(3):187-194.
Nakashima Y, Yamamoto T, Fukushi JI, et al. Transtrochanteric rotational osteotomy for avascular necrosis of the femoral head after unstable slipped capital femoral epiphysis: 10-year clinical results. J Orthop Sci. 2016;21(6):831-835. doi:10.1016/j.jos.2016.06.014
Zhang HX, Zhang XP, Xiao GY, et al. In vitro and in vivo evaluation of calcium phosphate composite scaffolds containing BMP-VEGF loaded PLGA microspheres for the treatment of avascular necrosis of the femoral head. Mater Sci Eng C Mater Biol Appl. 2016;60:298-307. doi:10.1016/j. msec.2015.11.055
Ashraf M, Subramanian V, Narayanan S, Mohan M. Tensor fascia lata muscle pedicle grafting for avascular necrosis femoral head. Int J Res Orthop. 2016;2(4):333-339. doi:10.18203/issn.2455-4510.IntJResOrthop20164164
Kazemi-Khoo N. Successful treatment of diabetic foot ulcers with low-level laser therapy. Foot. 2006;16(4):184- 187. doi:10.1016/j.foot.2006.05.004
Dahmardehei M, Kazemikhoo N, Vaghardoost R, et al. Effects of low level laser therapy on the prognosis of split-thickness skin graft in type 3 burn of diabetic patients: a case series. Lasers Med Sci. 2016;31(3):497-502. doi:10.1007/ s10103-016-1896-9
Maia ML, Bonjardim LR, Quintans Jde S, Ribeiro MA, Maia LG, Conti PC. Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review. J Appl Oral Sci. 2012;20(6):594-602.
Joensen J, Gjerdet NR, Hummelsund S, Iversen V, Lopes- Martins RA, Bjordal JM. An experimental study of low-level laser therapy in rat Achilles tendon injury. Lasers Med Sci. 2012;27(1):103-111. doi:10.1007/s10103-011-0925-y
Zati A, Desando G, Cavallo C, et al. Treatment of human cartilage defects by means of Nd:YAG Laser Therapy. J Biol Regul Homeost Agents. 2012;26(4):701-711.
Araujo BF, Silva LI, Meireles A, et al. Effects of Low- Level Laser Therapy, 660 nm, in Experimental Septic Arthritis. ISRN Rheumatol. 2013;2013:341832. doi:10.1155/2013/341832
Lopes-Martins RA, Penna SC, Joensen J, Iversen VV, Bjordal JM. Low Level Laser Therapy [LLLT] in Inflammatory and Rheumatic Diseases:A Review of Therapeutic Mechanisms. Curr Rheumatol Rev. 2007;3(2):147-154. doi:10.2174/157339707780619421
Gur A, Sarac AJ, Cevik R, Altindag O, Sarac S. Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med. 2004;35(3):229-235. doi:10.1002/lsm.20082
Goldman JA, Chiapella J, Casey H, et al. Laser therapy of rheumatoid arthritis. Lasers Surg Med. 1980;1(1):93-101.
Baxter GD, Bleakley C, McDonough S. Clinical effectiveness of laser acupuncture: a systematic review. J Acupunct Meridian Stud. 2008;1(2):65-82. doi:10.1016/ s2005-2901(09)60026-1
Banaszkiewicz PA. Idiopathic Bone Necrosis of the Femoral Head. Early Diagnosis and Treatment. In: Banaszkiewicz PA, Kader DF, eds. Classic Papers in Orthopaedics. London: Springer; 2014:121-123.
Set T, Maras I, Khan AS, Ozdemir H. Management of Legg-Calve-Perthes disease with acupuncture: a case report. Acupunct Med. 2013;31(1):105-107. doi:10.1136/ acupmed-2012-010255
Calori GM, Mazza E, Colombo A, Mazzola S, Colombo M. Core decompression and biotechnologies in the treatment of avascular necrosis of the femoral head. EFORT Open Rev. 2017;2(2):41-50. doi:10.1302/2058-5241.2.150006
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