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Bifosfonat Tedavisinin Femur Başı Avasküler Nekrozu Üzerine Etkisi
Effect of Biphosphonate Treatment on Femur Head Avascular Necrosis
Received Date : 30 Apr 2022
Accepted Date : 13 Dec 2022
Available Online : 19 Dec 2022
Doi: 10.31609/jpmrs.2022-91045 - Makale Dili: EN
J PMR Sci. 2023;26(1):108-11
ÖZET
Avasküler nekroz (AVN), kemiğin kan dolaşımının bozulması sonucunda, kemik doku hücrelerinin kısmen veya tamamının ölmesiyle sonuçlanan, ilerleyici bir bozukluktur. AVN oluşumunda en sık karşılaşılan etiyolojik faktörler; alkolizm, kortikosteroid kullanımı, travma, orak hücreli anemi, sistemik lupus eritematozus ve yağ embolisidir. Bunlardan kortikosteroid kullanımı, femur başı AVN oluşumunda en önemli risk faktörüdür. Sınırlı sayıda literatürde, tedavide bifosfonatlar-alendronatın etkinliğine dair umut verici sonuçlar bildirilmiştir. Bu yazıda, böbrek nakli sonrası kortikosteroid kullanımı bağlı bilateral femur başı AVN gelişen ve osteoporoz nedeniyle 4 yıldır alendronat tedavisi alan bir hasta sunuldu. Femur başında çökme olmadan önce başlanan alendronat tedavisinin, kalça eklemlerinde semptomatik rahatlama sağladığı düşünüldü.
ABSTRACT
Avascular necrosis (AVN) is a progressive disorder that results in partial or complete death of bone tissue cells due to impaired blood circulation in the bone. The most common etiological factors in AVN formation are alcoholism, corticosteroid use, trauma, sickle cell anemia, systemic lupus erythematosus, and fat embolism. Among these, corticosteroid use is the most crucial risk factor for femoral head AVN development. Promising results regarding the efficiency of bisphosphonates-alendronate in treatment have been reported in a limited number of literature sources. In this article, a patient who developed bilateral AVN of the femoral head due to corticosteroid use after kidney transplantation and received alendronate treatment for 4 years due to osteoporosis is presented. It was thought that alendronate treatment started before the femoral head collapsed provided symptomatic relief in the hip joints.
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