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Schmerz (Berlin, Germany) · 2004

[Pain management in non-juvenile, aseptic osteonecrosis].

Аннотация на английскомСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Jäger M, Werner A, Lentrodt S, Mödder U, Krauspe R

Аннотация

BACKGROUND: Adult aseptic osteonecrosis (ON) represents a clinical picture with unexplained etiology. Since curative treatment of this disease often succeeds only in the early stage, pain therapy plays an important role in the treatment process.

METHOD: We compared established and novel treatment options for ON as well as our own results after i.v. administration of the prostacyclin analogue iloprost with corresponding studies in the literature.

RESULTS: In addition to treatment with nonsteroidal antirheumatic agents and opioids, surgical "core decompression," vasoactive medications, and hyperbaric oxygenation are effective. Treatment with iloprost for 5 days resulted in highly significant pain reduction.

CONCLUSION: Symptomatic treatment is indicated in all stages of ON and curative treatment in stage I and early stage II. In cases of disease progression in the large joints, early endoprosthetic replacement is indicated to avoid secondary damage. In addition to employing vasoactive substances, a further curative treatment approach could be the use of mesenchymal stem cells.

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