Preventive effects of intramedullary injection with salvia miltiorrhiza on steroid-induced necrosis of the femoral head

Qingde WA; Tianhong ZHANG; Yi LIU

ABSTRACT

BACKGROUND:

The pathogenesis of avascular necrosis of the femoral head is still uncertain,so the treatment is not favorable.

OBJECTIVE:

To study the feasibility and mechanism of intramedullary injection with salvia miltiorrhiza for preventing of steroid-induced necrosis of the femoral head.DESIGN,TIME AND

SETTING:

Randomized controlled animal trial was performed at Zunyi Medical College between April 2005 and May 2007.MATERIALSThirty 6-month-old healthy rabbits,half amount of male and female,weighing(2.5?0.25) g,were randomly divided into three groups(n=10)control,model,and prevention groups.

METHODS:

Normal saline was injected into the control group.Prednisolone was injected into model group,7.5 mg/kg,two times per week for 8 weeks.Glucocorticoid-induced animal model in the prevention group was intramedullary injected with salvia miltiorrhiza,0.3-0.5 cm below the third trochanter of the femur,0.4 mL/kg,twice a week for 8 weeks.MAIN OUTCOME

MEASURES:

Blood lipids level,serum calcium and phosphorus were measured;X-ray,emission computerized tomographic(ECT) and histopathology were performed.

RESULTS:

The serum calcium and phosphorus in model group were remarkably reduced.X-ray showed inhomogeneous density of the femoral head,with irregular radiolucent area,obscure structures of bone-trabecula,but intact femoral head and normal joint space.The blood flow and blood pool showed decreasing radioactive distribution of the femoral head,and local concentration of nuclide in the delayed phase in the model group.Histopatholgical observation suggested that the cortical bone was thinned,with thin bone-trabecula and irregular arrangement,necrosed bone marrow and pimelosis and increased bone lacuna.The calcium-phosphorus product of prevent group was increased;X-ray showed normal femoral head appearance and normal bone density except unclear bone-trabecula.ECT showed the dynamic and static images of the prevention group were similar as normal imaging of rabbits.In addition,histopatholgical observation suggested the rate of empty lacuna was decreased,and bone trabecula minimally thinned with ordered arrangement.

CONCLUSION:

Salvia miltiorrhiza injection plays a good effective role in the prevention of steroid-induced avascular necrosis of femoral head through improving hemorheology and reducing rate of empty lacuna.