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Chinese herbal Huo-Gu formula for the treatment of steroid-associated osteonecrosis of femoral head: A 14-year follow-up of convalescent SARS patients.
Huang, Zeqing; Fu, Fanyu; Ye, Hengli; Gao, Huanhuan; Tan, Biao; Wang, Rongtian; Lin, Na; Qin, Ling; Chen, Weiheng.
  • Huang Z; Wangjing Hospital, China Academy of Chinese Medical Sciences, PR China.
  • Fu F; Guizhou University of Traditional Chinese Medicine, PR China.
  • Ye H; Guizhou University of Traditional Chinese Medicine, PR China.
  • Gao H; Wangjing Hospital, China Academy of Chinese Medical Sciences, PR China.
  • Tan B; Wangjing Hospital, China Academy of Chinese Medical Sciences, PR China.
  • Wang R; Orthopaedic Center, The Third Affiliated Hospital of Beijing University of Chinese Medicine, PR China.
  • Lin N; Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, PR China.
  • Qin L; Department of Orthopaedics & Traumatology, Musculoskeletal Research Laboratory, Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
  • Chen W; Translational Medicine R&D Center, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, PR China.
J Orthop Translat ; 23: 122-131, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-1026231
ABSTRACT

PURPOSE:

The coronavirus disease 2019 (COVID-19) reminds us of the severe acute respiratory syndrome (SARS) outbreak in 2003, and up to date, corticosteroid is commonly administrated to severe patients with COVID-19. Osteonecrosis of the femoral head (ONFH) is a common disabling complication among convalescent SARS patients who received corticosteroid therapy. In China, a considerable number of convalescent SARS patients with steroid-associated ONFH had undergone conservative treatment by traditional Chinese medicine, and this study aims to evaluate the long-term results of a spleen-invigorating Huo-Gu formula (HGF) therapy in these patients. PARTICIPANTS AND

METHODS:

A total of 33 convalescent SARS patients (9 males and 24 females) with bilateral steroid-associated ONFH (66 hips) were enrolled in this study. All patients received oral HGF therapy for 6 months when they were confirmed the diagnosis of steroid-associated ONFH. They had been regularly followed up at an interval of 1 year. Harris hip score and medical imaging modalities, including plain radiography, computed tomography and magnetic resonance imaging, were performed to evaluate the outcomes.

RESULTS:

Based on average 14 years of follow-up of HGF therapy (ranging from 6 to 16 years), 38 hips (57%) among the 66 hips developed definite osteoarthritis, and 14 hips (26%) in 53 precollapse hips (Association Research Circulation Osseous [ARCO] Stage I or II) progressed to femoral head collapse (ARCO Stage III or IV). Only five patients (also 5 hips) underwent total hip arthroplasty, and the mean hip survival time was over 15 years by the Kaplan-Meier analysis. We observed a mean Harris hip score of 63 points, which represented the reserve of 55% in pain score and 70% in physical function score. The severity of groin pain was not correlated to the severity of osteoarthritis.

CONCLUSION:

Chinese herbal HGF therapy demonstrates beneficial effects on preventing femoral head collapse, delaying total hip arthroplasty, and maintaining physical function in the treatment of steroid-associated ONFH. HGF therapy might be therefore a good alternative for the treatment of steroid-associated ONFH secondary to rheumatologic and infection diseases. TRANSLATIONAL POTENTIAL OF THE ARTICLE HGF therapy might be a good alternative for the treatment of steroid-associated ONFH secondary to rheumatologic and infectious diseases.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Prognostic study Topics: Traditional medicine Language: English Journal: J Orthop Translat Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Prognostic study Topics: Traditional medicine Language: English Journal: J Orthop Translat Year: 2020 Document Type: Article