title: Steroid-induced femoral head osteonecrosis in immune thrombocytopenia treatment with osteochondral autograft transplantation.
abstract: Osteonecrosis of the femoral head is a devastating complication of steroid administration and has rarely been observed in the treatment of immune thrombocytopenia. The treatment of osteochondral defects in advanced stages of avascular necrosis (AVN), characterized by collapse of the subchondral bone, remains an unsolved burden in orthopedic surgery. In this report, we present a case of a 19-year-old female that was admitted in the Emergency Department with walking disability and painful hip joint movement due to steroid-induced femoral head osteonecrosis. Two years before she was diagnosed with immune thrombocytopenia, for which she received pulse steroid therapy with high dose of dexamethasone and underwent a splenectomy. This case report is the first to describe the use of osteochondral autograft transplantation as a treatment of steroid-induced AVN of the femoral head due to immune thrombocytopenia at the age of 19 years with very good clinical and radiological results 3 years postoperatively.
authors.affiliation: "Evangelismos" General Hospital of Athens, 45-47 Ipsilantou Str., 10676, Athens, Greece, fotova@yahoo.gr.
authors.forename: Vasileios Ch
authors.initials: VCh
authors.lastname: Fotopoulos
authors.forename: George
authors.initials: G
authors.lastname: Mouzopoulos
authors.forename: Themistoklis
authors.initials: T
authors.lastname: Floros
authors.forename: Matthaios
authors.initials: M
authors.lastname: Tzurbakis
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005269:Femur / Q000637:transplantation*; D005271:Femur Head Necrosis / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D051457:Hyaline Cartilage / Q000637:transplantation*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone