HEMOSTATIC FACTORS IN STEROID AND NON-STEROID INDUCED OSTEONECROSIS OF THE FEMORAL HEAD
Nishii T, Sugano N, Miki H, Yoshikawa H, Nakumura N, Sakai T
Department of Orthopaedic Surgery, Osaka University Medical School, Osaka, Japan

Association between hemostatic function and osteonecrosis of the femoral head (ONFH) has been differently reported among researchers. This paper focused on the influence of hemostatic disorders in patients with ONFH associated with steroid or alcohol. Protein C, S, ATIII, plasminogen, tissue plasminogen activator (tPA), plasminogen activator inhibitor I (PAI-I), and homocysteine were examined in 27 patients with steroid induced ONFH (Group A) and 25 patients with non-steroid induced ONFH (Group B), including 22 patients with alcohol abuse. TPA and PAI-1 were also examined in 19 normal volunteers (Group C). Six patients in Group A showed low Protein S or high homocysteine and 2 in Group B showed high homocysteine. There was no statistical differences in the level of tPA, PAI-1 and tPA/PAI-1 ratio among the 3 groups after adjustment for age and sex. PAI-1 levels were significantly elevated in 6 of 25 in Group B while none in Group A and C. Association between hemostatic function and ONFH may differ according to the etiological factors and patients associated with alcohol abuse may have prolonged fibrinolytic disorder.