Evaluation of results of conservative therapy in patients with transient osteoporosis of hip

Abstract

The present study aimed to review the general characteristics of 18 cases diagnosed with transient osteoporosis of the hip (TOH) in our hospital within a 3-year period and to present their follow-up results after conservative treatment. A retrospective evaluation was made of the treatment and results of followup of TOH cases using physical examination and laboratory findings, hip radiographs and magnetic resonance imaging (MRI) and Harris Hip Scores (HHS). The mean duration of complaints of 6 females (mean age, 34.3 ± 4.3 years) and 12 males (mean age, 40.7 ± 10.5 years) was 6.1 ± 2.7 weeks before the treatment. Three female patients had a history of giving birth by cesarean delivery. None of the patients had any history of trauma. MRI revealed increased intensity in T2 sequences and decreased intensity in T1 sequences in the proximal aspect of the femur. None of the patients had subchondral collapse or intra-articular effusion. For 3 female patients who were breastfeeding, no medical therapy was given, but only hyperbaric oxygen (HBO) therapy and forearm crutches. As standard management, the other patients were prevented from weight-bearing with the use of forearm crutches and medical therapy of diclofenac sodium, acetylsalicylic acid, and risedronate sodium was administered and additional HBO therapy. Clinical and radiological improvements were observed in all patients. None of the patients had avascular necrosis (AVN) of the femoral head. There was no record of therapy-related complications. While HHS was 55.6 ± 7.8 before the treatment, it increased to 88.8 ± 5.8 in the 3rd month and to 96.0 ± 1.8 in the 6th month after the treatment. This change in score over time was found to be significant.