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Long Term Anticoagulation (4–16 Years) Stops Progression of Idiopathic Hip Osteonecrosis Associated with Familial Thrombophilia
Joint Authors
Glueck, Charles J.
Freiberg, Richard A.
Wissman, Robert
Wang, Ping
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-01-29
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
In 6 patients with familial thrombophilia (5 Factor V (FV) Leiden heterozygotes, 1 with resistance to activated protein C (RAPC)), we prospectively assessed whether continuous longterm (4–16 years) anticoagulation would prevent progression of idiopathic osteonecrosis (ON), ameliorate pain, and facilitate functional recovery.
Four men and 2 women (9 hips, 8 Ficat stage II, 1 stage I) were anticoagulated with enoxaparin (60 mg/day) for 3 months and subsequently with Coumadin, Xarelto, or Pradaxa, warranted by ≥2 prior thrombotic events.
Anticoagulation was continued for 4, 4, 9, 13, 13, and 16 years, with serial clinical and X-ray follow-up.
On 4–16-years anticoagulation, 9 hips in the 6 patients (8 originally Ficat II, 1 Ficat I) remained unchanged, contrasted to untreated ON Ficat stage II, where 50%–80% of hips progress to collapse (Ficat stages III-IV) within 2 years after diagnosis.
Within 3, 3, 3, 9, and 16 months after starting anticoagulation, 5 patients became pain-free and remained asymptomatic throughout follow-up; the 6th patient required Percocet for pain.
There were no significant bleeding episodes.
Long term (4–16 years) anticoagulation initiated in Ficat stages I-II of idiopathic hip ON in patients with FV-RAPC changes the natural history of ON, stopping progression, resolving pain, and restoring function.
American Psychological Association (APA)
Glueck, Charles J.& Freiberg, Richard A.& Wissman, Robert& Wang, Ping. 2015. Long Term Anticoagulation (4–16 Years) Stops Progression of Idiopathic Hip Osteonecrosis Associated with Familial Thrombophilia. Advances in Orthopedics،Vol. 2015, no. 2015, pp.1-7.
https://search.emarefa.net/detail/BIM-1053802
Modern Language Association (MLA)
Glueck, Charles J.…[et al.]. Long Term Anticoagulation (4–16 Years) Stops Progression of Idiopathic Hip Osteonecrosis Associated with Familial Thrombophilia. Advances in Orthopedics No. 2015 (2015), pp.1-7.
https://search.emarefa.net/detail/BIM-1053802
American Medical Association (AMA)
Glueck, Charles J.& Freiberg, Richard A.& Wissman, Robert& Wang, Ping. Long Term Anticoagulation (4–16 Years) Stops Progression of Idiopathic Hip Osteonecrosis Associated with Familial Thrombophilia. Advances in Orthopedics. 2015. Vol. 2015, no. 2015, pp.1-7.
https://search.emarefa.net/detail/BIM-1053802
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1053802