Idiopathic aseptic necrosis of the femoral head in children who are professionally engaged in gymnastics: A literature review

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BACKGROUND: Aseptic necrosis of the femoral head in school-age children is a severe, rapidly progressive degenerative and dystrophic disease. A significant proportion of girls aged >10 years with osteonecrosis of the femoral head have been professionally engaged in rhythmic gymnastics. The relationship between professional sports, in particular rhythmic gymnastics, and the development of this pathology and the mechanism of impaired blood flow in the femoral head in such cases remains unclear. The severity of the course and serious consequences of this disease in the form of multidimensional deformities of the femoral head, early arthrosis of the hip joint, and persistent disability, require close attention.

AIM: To analyze modern world literature data on the etiology, pathomechanics, and features of the course and treatment of idiopathic aseptic necrosis of the femoral head in children professionally engaged in rhythmic gymnastics.

MATERIALS AND METHODS: A literature search on the problem of idiopathic aseptic necrosis of the femoral head in children professionally engaged in rhythmic gymnastics in the open information databases was conducted in PubMed, Science Direct, and Library with an analysis depth of 20 years.

RESULTS: The analysis of publications on the osteonecrosis of the femoral head allowed us to talk about the etiological connection of this condition with professional rhythmic gymnastics, namely, high-intensity repetitive loads on the hip joint of a child. Studies using in vivo laser Doppler flowmetry and 3D computer modeling prove the occlusion of blood vessel branches encircling the femur under excessive mechanical stress on the femoral head and potentially unfavorable positions in the hip joint – overextension (hyperextension), external rotation, and abduction.

CONCLUSIONS: Professional gymnastics can be a risk factor for the development of osteonecrosis of the femoral head. Frequent late disease diagnoses with the development of severe deformity of the femoral head and end-stage coxarthrosis requiring total hip replacement in adolescents determine the need for early identification of the causes of hip pain in children engaged in gymnastics. The findings will help improve treatment results and reduce the number of organ replacement interventions.

作者简介

Ivan Pozdnikin

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pozdnikin@gmail.com
ORCID iD: 0000-0002-7026-1586
SPIN 代码: 3744-8613

MD, PhD, Cand. Sci. (Med.)

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Pavel Bortulev

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pavel.bortulev@yandex.ru
ORCID iD: 0000-0003-4931-2817
SPIN 代码: 9903-6861

MD, PhD, Cand. Sci. (Med.)

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Dmitrii Barsukov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

编辑信件的主要联系方式.
Email: dbbarsukov@gmail.com
ORCID iD: 0000-0002-9084-5634
SPIN 代码: 2454-6548

MD, PhD, Cand. Sci. (Med.)

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603

参考

  1. Samusenkov OI, Samusenkova EI, Bobrova DD. The importance of children’s sports, student sports and elite sports in Russia. Flagman of Science 2023;5(5):501–503. EDN: EIAOHC
  2. Moreno-Agostino D, Daskalopoulou C, Wu YT, et al. The impact of physical activity on healthy ageing trajectories: evidence from eight cohort studies. Int J Behav Nutr Phys Act. 2020;17(1):92. doi: 10.1186/s12966-020-00995-8
  3. Kirizleeva VV, Pushkareva IN. The syndrome of «children’s early sports», accompanied by forced training in athletics. In: Current problems of science and education: materials of the International Forum dedicated to the 300th anniversary of the Russian Academy of Sciences, Ekaterinburg, December 12–13, 2022. Part 2. Ekaterinburg: Ural State Pedagogical University, 2023. EDN: SCNEIE
  4. Bell DR, DiStefano L, Pandya NK, et al. The public health consequences of sport specialization. J Athl Train. 2019;54(10):1013–1020. doi: 10.4085/1062-6050-521-18
  5. Smucny M, Parikh SN, Pandya NK. Consequences of single sport specialization in the pediatric and adolescent athlete. Orthop Clin North Am. 2015;46(2):249–258. doi: 10.1016/j.ocl.2014.11.004
  6. Caine D, DiFiori J, Maffulli N. Physeal injuries in children’s and youth sports: reasons for concern? Br J Sports Med. 2006;40(9):749–760. doi: 10.1136/bjsm.2005.017822
  7. Hawkins D, Metheny J. Overuse injuries in youth sports: biomechanical considerations. Med Sci Sports Exerc. 2001;33(10):1701–1707. doi: 10.1097/00005768-200110000-00014
  8. Arhipova YuA, Veselkina TE, Radovickaya EV, et al. Some provoking factors for the occurrence of sports injuries in rhythmic gymnastics. Scientific notes of the University. P.F. Lesgafta. 2023;8(222):21–26. EDN: BDNOTG doi: 10.34835/issn.2308-1961.2023.08.p21-26
  9. Di Maria F, Testa G, Sammartino F, et al. Treatment of avulsion fractures of the pelvis in adolescent athletes: a scoping literature review. Front Pediatr. 2022;10. doi: 10.3389/fped.2022.947463
  10. Williams E, Lloyd R, Moeskops S, et al. Injury pathology in young gymnasts: a retrospective analysis. Children (Basel). 2023;10(2):303. doi: 10.3390/children10020303
  11. Hart E, Meehan WP 3rd, Bae DS, et al. The young injured gymnast: a literature review and discussion. Curr Sports Med Rep. 2018;17(11):366–375. doi: 10.1249/JSR.0000000000000536
  12. Torgashin AN, Rodionova SS, SHumskij AA, et al. Treatment of aseptic necrosis of the femoral head. Clinical guidelines. Rheumatology Science and Practice. 2020;58(6):637–645. EDN: EWKHOY doi: 10.47360/1995-4484-2020-637-645
  13. Blümel S, Leunig M, Manner H, et al. Avascular femoral head necrosis in young gymnasts: a pursuit of aetiology and management. Bone Jt Open. 2022;3(9):666–673. doi: 10.1302/2633-1462.39.BJO-2022-0100.R1
  14. Tihilov RM, Shubnyakov II, Myasoedov AA, et al. Comparison of different core decompression techniques for treatment of early stages of osteonecrosis of the femoral head. Traumatology and Orthopedics of Russia. 2016;56(3):637–645. EDN: WYPMTH doi: 10.21823/2311-2905-2016-22-3-7-21
  15. Odarchenko DI, Dzyuba GG, Erofeev SA, et al. Problems of diagnosis and treatment of aseptic necrosis of the femoral head in contemporary traumatology and orthopedics (literature review). Orthopaedic Genius. 2021;27(2):270–276. EDN: VQSUJQ doi: 10.18019/1028-4427-2021-27-2-270-276
  16. Migliorini F, Maffulli N, Baroncini A, et al. Failure and progression to total hip arthroplasty among the treatments for femoral head osteonecrosis: a Bayesian network meta-analysis. Br Med Bull. 2021;138(1):112–125. doi: 10.1093/bmb/ldab006
  17. Hines JT, Jo WL, Cui Q, et al. Osteonecrosis of the femoral head: an updated review of ARCO on pathogenesis, staging and treatment. J Korean Med Sci. 2021;36(24):e177. doi: 10.3346/jkms.2021.36.e177
  18. Min BW, Song KS, Cho CH, et al. Untreated asymptomatic hips in patients with osteonecrosis of the femoral head. Clin Orthop Relat Res. 2008;466:1087–1092. doi: 10.1007/s11999-008-0191-x
  19. Cooper C, Steinbuch M, Stevenson R, et al. The epidemiology of osteonecrosis: findings from the GPRD and THIN databases in the UK. Osteoporos Int. 2010;21:569–577. doi: 10.1007/s00198-009-1003-1
  20. Calder JD, Hine AL, Pearse MF, et al. The relationship between osteonecrosis of the proximal femur identified by MRI and lesions proven by histological examination. J Bone Joint Surg Br. 2008;90(2):154–158. doi: 10.1302/0301-620X.90B2.19593
  21. Tikhilov RM, Shubnyakov II, Kovalenko AN, et al. Guide to surgery of the hip joint. Vol. 1. Saint Petersburg: RNIITO im. R.R. Vredena; 2014. (In Russ.) EDN: TMKDDR
  22. Radl R, Hungerford M, Materna W, Rehak P, et al. Higher failure rate and stem migration of an uncemented femoral component in patients with femoral head osteonecrosis than in patients with osteoarthrosis. Acta Orthop. 2005;76(1):49–55. doi: 10.1080/00016470510030319
  23. Luke A, Lazaro RM, Bergeron MF, et al. Sportsrelated injuries in youth athletes: is overscheduling a risk factor? Clin J Sport Med. 2011;21(4):307–314. doi: 10.1097/JSM.0b013e3182218f71
  24. Rose MS, Emery CA, Meeuwisse WH. Sociodemographic predictors of sport injury in adolescents. Med Sci Sports Exerc. 2008;40(3):444–50. doi: 10.1249/MSS.0b013e31815ce61a
  25. Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971;53(3):406–419.
  26. Nepple JJ, Vigdorchik JM, Clohisy JC. What Is the association between sports participation and the development of proximal femoral cam deformity? A systematic review and meta-analysis. Am J Sports Med. 2015;43(11):2833–2840. doi: 10.1177/0363546514563909
  27. Rosenfeld SB, Herring JA, Chao JC. Legg-Calve-Perthes disease: a review of cases with onset before six years of age. J Bone Joint Surg Am. 2007;89(12):2712–2722. doi: 10.2106/JBJS.G.00191
  28. Mazda K, Pennecot GF, Zeller R, et al. Perthes’ disease after the age of twelve years. Role of the remaining growth. J Bone Joint Surg Br. 1999;81:696–698.
  29. Zhi X, Wu H, Xiang C, et al. Incidence of total hip arthroplasty in patients with Legg-Calve-Perthes disease after conservative or surgical treatment: a meta-analysis. Int Orthop. 2023;47(6):1449–1464. doi: 10.1007/s00264-023-05770-5
  30. Ezhov IYu, Ezhov YuI. Post-traumatic aseptic necrosis of the femoral head. Traumatology and Orthopedics of Russia. 1996;(1):22–25. (In Russ.)
  31. Singh M, Singh B, Sharma K, et al. A molecular troika of angiogenesis, coagulopathy and endothelial dysfunction in the pathology of avascular necrosis of femoral head: a comprehensive review. Cells. 2023;12(18):2278. doi: 10.3390/cells12182278
  32. Shabaldin NA, Shabaldin AV. Molecular foundations of the etiology and pathogenesis of Legg-Calve-Perthes disease and prospects for targeted therapy: a literature review. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2022;10(3):295–307. EDN: VFUCXQ doi: 10.17816/PTORS101679
  33. Kealey WD, Mayne EE, McDonald W, et al. The role of coagulation abnormalities in the development of Perthes’ disease. J Bone Joint Surg Br. 2000;82(5):744–746. doi: 10.1302/0301-620x.82b5.10183
  34. Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971;53(3):406–419.
  35. McNitt-Gray JL, Hester DM, Mathiyakom W, et al. Mechanical demand and multijoint control during landing depend on orientation of the body segments relative to the reaction force. J Biomech. 2001;34:1471–1482. doi: 10.1016/s0021-9290(01)00110-5
  36. Nduaguba AM, Sankar WN. Osteonecrosis in adolescent girls involved in high-impact activities: could repetitive microtrauma be the cause?: a report of three cases. JBJS Case Connect. 2014;4(2):e35. doi: 10.2106/JBJS.CC.M.00273
  37. Larson AN, Kim HK, Herring JA. Female patients with late-onset Legg-Calve-Perthes disease are frequently gymnasts: is there a mechanical etiology for this subset of patients? J Pediatr Orthop. 2013;33(8):811–815. doi: 10.1097/BPO.0000000000000096
  38. Assouline-Dayan Y, Chang C, Greenspan A, et al. Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum. 2002;32(2):94–124.
  39. Mihara K, Hirano T. Standing is a causative factor in osteonecrosis of the femoral head in growing rats. J Pediatr Orthop. 1998;18(5):665–669. doi: 10.1097/00004694-199809000-00022
  40. Yoshida G, Hirano T, Shindo H. Deformation and vascular occlusion of the growing rat femoral head induced by mechanical stress. J Orthop Sci. 2000;5(5):495–502. doi: 10.1007/s007760070029
  41. Zhang JF, Yang CJ, Wu T, et al. A two-degree-of-freedom hip exoskeleton device for an immature animal model of exercise-induced Legg-Calve-Perthes disease. Proc Inst Mech Eng H. 2009;223(8):1059–1068. doi: 10.1243/09544119JEIM597
  42. Salter RB. The effects of continuous compression on living articular cartilage an experimental investigation. J Bone Joint Surg Am. 1960;42(1):31–90.
  43. Georgiadis AG, Seeley MA, Yellin JL, et al. The presentation of Legg-Calvé-Perthes disease in females. J Child Orthop. 2015;9(4):243–247. doi: 10.1007/s11832-015-0671-y
  44. Nötzli HP, Siebenrock KA, Hempfing A, et al. Perfusion of the femoral head during surgical dislocation of the hip. Monitoring by laser Doppler flowmetry. J Bone Joint Surg Br. 2002;84(2):300–304. doi: 10.1302/0301-620x.84b2.12146
  45. Ganz R, Huff TW, Leunig M. Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application. Instr Course Lect. 2009;58:241–255.
  46. Luthra JS, Al-Habsi S, Al-Ghanami S, et al. Understanding painful hip in young adults: a review article. Hip Pelvis. 2019;31(3):129–135. doi: 10.5371/hp.2019.31.3.129
  47. Hölmich P. Long-standing groin pain in sportspeople falls into three primary patterns, a “clinical entity” approach: a prospective study of 207 patients. Br J Sports Med. 2007;41(4):247–252. doi: 10.1136/bjsm.2006.033373
  48. Rossi F, Dragoni S. Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol. 2001;30(3):127–131. doi: 10.1007/s002560000319
  49. Kozhevnikov AN, Barsukov DB, Gubaeva AR. Legg–Calvé–Perthes disease presenting with osteoarthritis: Mechanisms of the development and prospects of conservative therapy using bisphosphonates. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2023;11(3):405–416. doi: 10.17816/PTORS456498
  50. Giraudo C, Fichera G, Pilati L, et al. COVID-19 musculoskeletal involvement in children. Front Pediatr. 2023;11. doi: 10.3389/fped.2023.1200877
  51. Bashkova IB, Madyanov IV, Mihajlov AS. Osteonecrosis of the femoral head induced by a new coronavirus infection. Russian Medical Journal. 2022;(6):71–74. EDN: OORKNI
  52. Hassan AAA, Khalifa AA. Femoral head avascular necrosis in COVID-19 survivors: a systematic review. Rheumatol Int. 2023;43(9):1583–1595. doi: 10.1007/s00296-023-05373-8
  53. Assad SK, Sabah M, Kakamad FH, et al. Avascular necrosis of femoral head following COVID-19 infection. Ann Med Surg (Lond). 2023;85(9):4206–4210. doi: 10.1097/MS9.0000000000001098
  54. Weber AE, Bedi A, Tibor LM, et al. The hyperflexible hip: managing hip pain in the dancer and gymnast. Sports Health. 2015;7(4):346–358. doi: 10.1177/1941738114532431
  55. Papavasiliou A, Siatras T, Bintoudi A, et al. The gymnasts’ hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes. Skeletal Radiol. 2014;43(8):1071–1077. doi: 10.1007/s00256-014-1885-7
  56. Grieser T. Atraumatische und aseptische Osteonekrose großer Gelenke. Der Radiologe. 2019;59(7):647–662. (In Ger.) doi: 10.1007/s00117-019-0560-3
  57. Ganz R, Gill TJ, Gautier E, et al. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83(8):1119–1124. doi: 10.1302/0301-620x.83b8.11964
  58. Paley D. The treatment of femoral head deformity and coxa magna by the Ganz femoral head reduction osteotomy. Orthop Clin North Am. 2011;42(3):389–399. doi: 10.1016/j.ocl.2011.04.006
  59. Shannon BD, Trousdale RT. Femoral osteotomies for avascular necrosis of the femoral head. Clin Orthop Relat Res. 2004;(418):34–40. doi: 10.1097/00003086-200401000-00007
  60. Sodhi N., Acuna A., Etcheson J. Management of osteonecrosis of the femoral head: an up-to-date analysis of operative trends. Bone Joint Lett J. 2020;102(7 Suppl B):122–128. doi: 10.1302/0301-620X.102B7.BJJ-2019-1611.R1
  61. Xie H, Wang B, Tian S, et al. D. Retrospective long-term follow-up survival analysis of the management of osteonecrosis of the femoral head with pedicled vascularized iliac bone graft transfer. J Arthroplasty. 2019;34(8):1585–1592. doi: 10.1016/j.arth.2019.03.069
  62. Cheng Q, Zhao FC, Xu SZ, et al. Modified trapdoor procedures using autogenous tricortical iliac graft without preserving the broken cartilage for treatment of osteonecrosis of the femoral head: a prospective cohort study with historical controls. J Orthop Surg Res. 2020;15(1):1–8. doi: 10.1186/s13018-020-01691-w
  63. Calori GM, Mazza E, Colombo A, et al. Core decompression and biotechnologies in the treatment of avascular necrosis of the femoral head. EFORT Open Rev. 2017;2(2):41–50. doi: 10.1302/2058-5241.2.150006
  64. Sautina OP, Hazov PD. MRI-diagnostics early stage aseptic necrosis of the heads of the thighbone. I.P. Pavlov Russian Medical Biological Herald. 2008;(1):50–56. (In Russ.)
  65. Glickstein MF, Burk DL, Schiebler ML, et al. Avascular necrosis versus other diseases of the hip: sensitivity of MR imaging. Radiology. 1988;169(1):213–215. doi: 10.1148/radiology.169.1.3420260

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