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Rheumatology Advance Access published online on December 14, 2004
Rheumatology, doi:10.1093/rheumatology/keh505
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British Society for Rheumatology; all rights reserved
Received August 27, 2004
Accepted November 2, 2004

Original Papers

Effects of different corticosteroids on the development of osteonecrosis in rabbits

K. Miyanishi 1, T. Yamamoto 1*, T. Irisa 1, G. Motomura 1, S. Jingushi 1, K. Sueishi 2, and Y. Iwamoto 1

1 Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2 Division of Pathophysiological and Experimental Pathology, Department of Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

* To whom correspondence should be addressed.
T. Yamamoto, E-mail: yamataku{at}ortho.med.kyushu-u.ac.jp


  Abstract

Objectives. Osteonecrosis (ON) of the femoral head is a devastating complication occurring in patients receiving corticosteroid treatment. This study examined the effect of three corticosteroids on the development of ON in rabbits.

Methods. Thirty-nine rabbits were injected once intramuscularly with either 25 mg/kg prednisolone sodium succinate (PSL; 13 rabbits), 20 mg/kg methylprednisolone acetate (MPSL; 13 rabbits) or 20 mg/kg triamcinolone acetonide (TR; 13 rabbits). Four weeks after corticosteroid injection, the bilateral femora and humeri were examined histopathologically for the presence of ON. Haematological examinations were performed before and after corticosteroid injection.

Results. MPSL treatment (17/26 proximal femora, 65%) significantly increased ON incidence in the proximal femora compared with the levels seen after TR (4/26, 15%) or PSL (3/26, 12%) treatment (P<0.01). Although not significantly increased in comparison with rabbits receiving PSL treatment (1/26 proximal humeri, 4%), ON incidence within the proximal humeri was significantly increased in MPSL-treated rabbits (6/26, 23%) in comparison with those seen in rabbits receiving TR (0/26, 0%) treatment (P<0.05). Serum levels of cholesterol, triglyceride and free fatty acid were significantly higher 1, 2 and 4 weeks after corticosteroid treatment in rabbits treated with MPSL relative to rabbits receiving TR and rabbits with PSL treatment (P<0.05).

Conclusions. MPSL treatment significantly increased ON incidence in rabbits over levels seen after TR or PSL treatment.

Keywords: Osteonecrosis; Corticosteroid; Rabbit; Hip.
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