Treatment of osteonecrosis of the femoral head by botulinum toxin type A injection to the psoas muscle -A case report

• Published in: Anesthesia and pain medicine (Korean society of anesthesiologists) Vol. 12; no. 1; pp. 85 - 90
• Main Authors: Kim, Sung-Yul, Lee, Dong-Hyun, Kim, Sun-Hee, Cho, Yong-Hyun
• Format: Journal Article
• Language: English
• Published: 대한마취통증의학회 31.01.2017
• Subjects: 마취과학
• ISSN: 2383-7977; 1975-5171; 2383-7977
• DOI: 10.17085/apm.2017.12.1.85

Osteonecrosis of the femoral head (ONFH) can cause femoral head depression and cortical discontinuity. Treatment for ONFH remains challenging. We performed botulinum toxin type A injection to psoas major muscle in five patients with radiological femoral head collapse (Association Research Circulation Osseus classification stage III) who were non-responsive after two years of conservative treatment (tramadol 200 mg/day, mefenamic acid 1,000 mg/day). At two weeks after the procedure, their mean hip pain was decreased from 88 ± 0.4/100 mm to 22 ± 0.4/100 mm based on visual analogue scale (VAS). The pain was maintained at a minimum of 20/100 mm and a maximum of 30/100 mm in VAS for at least six weeks after the procedure. These values were mean ± SD. These patients were followed-up for 6 months. There was no exacerbation of pain from repeated (three times) botulinum toxin type A injection to the psoas major muscle. KCI Citation Count: 0