Pseudarthrosis (Pseudoarthrosis)

A pathologic entity characterized by deossification of a weight-bearing long bone, followed by bending and pathologic fracture, with inability to form normal BONY CALLUS leading to existence of the "false joint" that gives the condition its name. (Dorland, 27th ed)

Also Known As:

Networked: 1975 relevant articles (86 outcomes, 137 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Pain (Aches)
3.	Pathologic Constriction (Stenosis)
4.	Congenital Abnormalities (Deformity)
5.	Kyphosis

Experts

1.	Lenke, Lawrence G: 21 articles (01/2022 - 01/2002)
2.	Adogwa, Owoicho: 15 articles (06/2022 - 10/2011)
3.	Bridwell, Keith H: 14 articles (07/2014 - 01/2002)
4.	Choi, In Ho: 12 articles (09/2019 - 05/2005)
5.	Cho, Tae-Joon: 11 articles (09/2019 - 05/2005)
6.	Bydon, Mohamad: 10 articles (09/2022 - 02/2016)
7.	Riew, K Daniel: 10 articles (01/2022 - 05/2008)
8.	Vaccaro, Alexander R: 9 articles (10/2022 - 07/2004)
9.	Mei, Haibo: 9 articles (08/2022 - 01/2018)
10.	Wang, Jeffrey C: 9 articles (01/2021 - 02/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pseudarthrosis:

1.	TitaniumIBA 07/15/2006 - "To evaluate the safety and efficacy of using an integrated titanium mesh cage and pedicled rib flap for thoracic spine reconstruction in patients at high risk of pseudarthrosis. " 05/28/2021 - "Efficacy of the "Eiffel tower" double titanium elastic nailing in combined management of congenital pseudarthrosis of the tibia: preliminary outcomes of 17 cases with review of literature." 09/01/2023 - "Following ACDF with titanium cervical cages, subsidence is an anticipated postoperative occurrence and is not associated with an increased risk of pseudarthrosis." 12/01/2020 - "Complications included displacement of the titanium cage, removal of the lamina hook, formation of pseudoarthrosis, and internal fixation failure (with a rate of 7.7%-14.3%). " 05/01/2019 - "There was no titanium mesh subsidence, no pseudarthrosis or hardware failure at 1‑year follow-up. "
2.	recombinant human bone morphogenetic protein-2IBA 05/01/2011 - "The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of congenital pseudarthrosis of the tibia has been investigated in only one previous study, with promising results. " 04/01/2010 - "The purpose of this study was to analyze the pseudarthrosis rate in a large series of recombinant human bone morphogenetic protein-2 (rhBMP-2) augmented multilevel (> or =3 levels) anterior cervical fusions. " 12/01/2016 - "Recombinant human bone morphogenetic protein-2 was used in 17 patients for spine fusion, in 11 patients for the treatment of congenital pseudarthrosis of the tibia or tibial nonunion, in 5 patients for the management of femoral nonunion, in 5 patients for nonunions at other locations, and in 1 case for tibial shortening. " 04/01/2016 - "Effectiveness and safety of recombinant human bone morphogenetic protein-2 for adults with lumbar spine pseudarthrosis following spinal fusion surgery: A systematic review. " 04/01/2016 - "Effectiveness and safety of recombinant human bone morphogenetic protein-2 for adults with lumbar spine pseudarthrosis following spinal fusion surgery: A systematic review."
3.	Adrenal Cortex Hormones (Corticosteroids)IBA 01/01/2021 - "We conducted a meta-analysis of randomized trials to determine the efficacy of perioperative corticosteroid administration in reducing postoperative dysphagia as well as any adverse effects, such as pseudarthrosis and infection. " 05/01/2006 - "The risk for the development of a pseudarthrosis depends on clinical factors like corticoid medication, nicotine, incorrect alignment and improper mobilization. " 06/01/2010 - "Fluoroscopically guided local anesthetic/corticosteroid injection into the pseudarthrosis eliminated her residual right buttock pain for the duration of the local anesthetic only. "
4.	Bone Morphogenetic Proteins (Bone Morphogenetic Protein)IBA 11/17/2021 - "Pseudarthrosis was resected, and the defect was bridged with an iliac crest autograft, supplemented with bone morphogenetic protein, and fixed with an elastic stable intramedullary nail. " 03/01/2017 - "The use of bone morphogenetic proteins (BMP) and pseudarthrosis, a literature review." 08/01/2012 - "Masquelet's procedure and bone morphogenetic protein in congenital pseudarthrosis of the tibia in children: a case series and meta-analysis." 04/01/1996 - "Partially purified canine bone morphogenetic protein (cBMP) was used in the repair of a delayed union fracture and a pseudoarthrosis. " 04/01/2016 - "We performed a systematic review of the literature to determine the safety and efficacy of bone morphogenetic protein (BMP) compared with bone graft when used specifically for revision spinal fusion surgery secondary to pseudarthrosis. "
5.	2- cyclohexylidenhydrazo- 4- phenyl- thiazoleIBA 09/01/2023 - "The purpose of this study was to investigate the initial efficacy of a new telescopic rod in the treatment of congenital pseudarthrosis of tibia (CPT) in children. " 09/01/2022 - "Therefore, this study is to investigate the clinical efficacy and safety of a new "U"-shaped staple in the treatment of postoperative ankle valgus of congenital pseudarthrosis of the tibia (CPT). " 04/01/2019 - "This study assessed the outcomes, at skeletal maturity, for 34 patients in whom congenital pseudarthrosis of the tibia (CPT) had been treated with intramedullary (IM) rod fixation. " 12/01/2018 - "According to previously published studies, treating pediatric patients with congenital pseudarthrosis of the tibia (CPT) is challenging. " 06/01/2017 - "This study aimed to investigate the relationship between postoperative complications and fibular integrity in congenital pseudarthrosis of the tibia (CPT) in children. "
6.	polyetheretherketoneIBA 01/24/2020 - "A previous study found a 5-fold higher rate of pseudarthrosis with the use of PEEK devices compared with structural allograft in single-level ACDF. " 06/01/2023 - "Multivariate logistic regression analysis identified that PEEK cage implants (odds ratio [OR], 3.34; p =0.007) predicted pseudarthrosis development compared with structural allograft implantation. " 10/25/2022 - "For ACDF procedures, PEEK filled with autograft showed the highest percentages of subsidence and pseudoarthrosis. " 08/01/2022 - "Overall, evidence of radiographic fusion was achieved in 87 (91.6%) patients: five (10.2%) and three (6.5%) patients had pseudoarthrosis (P = 0.72) in the PEEK and allograft groups, respectively. " 11/01/2021 - "There is recent evidence to suggest that the use of polyetheretherketone (PEEK) interbodies are inherently associated with a higher rate of pseudarthrosis, in particular, at the C5-6 and C6-7 levels. "
7.	SteroidsIBA 01/01/2021 - "There was no significantly increased risk of pseudarthrosis in those receiving steroids compared with placebo or a control treatment (p = 0.13). " 03/01/1989 - "Congenital pseudarthrosis of the tibia: treatment with local steroid infiltration." 03/01/2009 - "Symptomatic pseudarthrosis after a traumatically disrupted congenital lumbar transverse process-ileum fusion (Richard disease) treated successfully with steroid injections: a case report." 03/01/2018 - "ISSNHL in the acute postoperative period of lumbar spinal fusion surgery presents a unique treatment dilemma because systemic steroids are routinely avoided over concerns of pseudarthrosis. " 10/01/2015 - "To date, studies using retropharyngeal steroid (RS) have not reported complications with local steroids such as infection, pseudarthrosis, and other systemic adverse effects. "
8.	Teriparatide (Parathar)FDA Link 09/01/2015 - "Because of the numerous positive results, from the point of view of teriparatide treatment, a multicentric, prospective randomized study on the treatment of aseptic pseudarthrosis should be initiated." 11/16/2023 - "Osteoporotic patients on teriparatide demonstrated lower reoperation and symptomatic pseudarthrosis rates 2 years postoperatively compared with osteopenic patients. " 08/15/2022 - "Key model assumptions were that administration of a 4-month preoperative teriparatide course reduced 2-year postoperative reoperation rates [for pseudarthrosis from 5% to 2.5% and for proximal junctional failure (PJF) from 15% to 5%]. " 11/16/2023 - "Limited data exist on the impact of teriparatide, an osteoanabolic compound, in limiting the rates of reoperation and pseudarthrosis after treatment of spinal deformity in patients with osteoporosis. "
9.	SuspensionsIBA 03/20/2012 - "The treatment with heterologous bone marrow cells suspension proved to be effective in the treatment of pseudarthrosis whereas cultures of heterologous bone marrow mesenchymal stromal cells did not show the same potential to aid bone healing." 04/01/1983 - "[Combination of external fixation unit with a floating suspension splint in the treatment of open lower leg fractures and infected tibial pseudarthrosis]." 01/01/1968 - "[Nailing and simultaneous partial suspension of hip according to Voss for prevention of pseudoarthrosis in abduction femoral neck fractures Pauwels 3]." 03/20/2012 - "This study evaluated the effectiveness of treating pseudarthrosis in rats by using bone marrow cell suspensions or cultures of bone marrow mesenchymal stromal cells Thirty-eight specific pathogen-free (SPF) animals were randomly assigned to four groups: Group 1, Control, without surgical intervention; Group 2 (Placebo), experimental model of femoral pseudarthrosis treated only with saline solution; Group 3, experimental model of femoral pseudarthrosis treated with heterologous bone marrow cells suspension; Group 4, experimental model of femoral pseudarthrosis treated with cultures of heterologous mesenchymal stromal cells from bone marrow. "
10.	Stainless Steel (Steel, Stainless)IBA 11/01/2022 - "The pooled proportion (95% CI) of pseudarthrosis was 15% (7-22%) for CoCr and 12% (- 8-32%) for stainless steel (SS) (n = 2 studies each; Chi2 = 0.07, p = 0.79). " 09/15/2008 - "Although the average follow-up in the Ti group was significantly shorter than in the SS group, the 4.75-mm titanium alloy construct resulted in improved maintenance of deformity correction at 2-years postop and a lower incidence of instrumentation-related complications (pseudarthrosis, rod breakage, and surgical revisions) compared to the 4.0-mm stainless steel construct. "

Therapies and Procedures

1.	Arthrodesis 07/01/2011 - "In this study, using the best widely available CT technologies and the ideal gold standard, thin-cut CT remained less than ideal for the assessment of lumbar arthrodesis/pseudarthrosis. " 09/01/1993 - "The risk of pseudarthrosis was significantly greater after a multiple-level arthrodesis than after a single-level arthrodesis (p < 0.01). " 08/01/1992 - "For distal radio-ulnar joint disorders, the Sauvé-Kapandji procedure, previously attributed to Lauenstein, of arthrodesis of the joint and distal ulnar pseudarthrosis is a very useful procedure, yet is not often practised. " 02/01/2013 - "The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. " 11/01/2010 - "The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. "
2.	Osteotomy 06/01/1993 - "This patient was treated successfully with excision of the pseudoarthrosis, shortening osteotomy of the ulna, grafting, and intramedullary fixation of both the radius and the ulna. " 04/01/2015 - "A central hook-rod construct is safe, controlled, and effective for applying compressive forces to close various spinal osteotomies without fixation failure or pseudarthrosis at the osteotomy site noted at a follow-up of 5 or more years. " 01/01/2017 - "The purposes of this study were to assess comparative rates of pseudoarthrosis (implant failure) at weaker points along lumbosacral junction and level of osteotomy, estimate overall incidence of implant failure, and comparatively analyze failures at different points along the construct. " 04/01/2012 - "The purpose of this study is to explore the outcomes of pedicle subtraction osteotomy (PSO) at the level of pseudarthrotic lesion combined with supplemental anterior fusion for patients suffering from kyphotic pseudarthrosis in AS. " 02/01/2008 - "The goals of this study were to develop a new intramedullary, rotation-stable locking device and evaluate it biomechanically and in vivo for maintenance of a critical size osteotomy gap in a model of conscious pseudarthrosis. "
3.	Reoperation 03/08/2019 - "Using these data, the authors estimated a price point of $5663 in order for BMP to be cost-neutral.CONCLUSIONSUse of BMP was associated with a significant reduction in the rates of revision surgery for pseudarthrosis. " 08/29/2023 - "From 99 patients with cervical revision surgery, ten patients (median age: 48, range 37-74; female: 5, male: 5) who underwent anterior revision surgery for pseudoarthrosis after ACDF with a minimal follow up of one year were included in the study. " 08/29/2023 - "The aim of the study was to analyze the outcome of patients who underwent anterior revision surgery for pseudoarthrosis after ACDF. " 07/01/2020 - "This study suggests that postmenopausal women may be prone to have higher rates of pseudarthrosis, PJK and revision surgery, although our results were not statistically significant. " 10/01/2018 - "In the current study, undergoing revision surgery, disc angle, and anterior disc height were observed to be associated with clinically-relevant pseudarthrosis. "
4.	Spinal Fusion (Spondylosyndesis) 01/01/2018 - "A high rate of symptomatic spinal pseudoarthrosis and a wide range of complications associated with the use of iliac crest bone graft (the gold standard) have prompted the spine surgery community to seek alternative options to promote spinal fusion. " 12/01/1994 - "Excision of pseudoarthrosis, followed by anterior and posterior spinal fusion were performed with good results. " 04/18/2019 - "Over 400000 Americans annually undergo spinal fusion surgeries, yet up to 40% of these procedures result in pseudoarthrosis even with iliac crest autograft, the current "gold standard" treatment. " 01/01/2022 - "Our study aimed to evaluate differences in outcomes of patients submitted to spinal fusion using different grafts measuring the effectiveness of spinal fusion rates, pseudarthrosis rates, and adverse events. " 01/01/2020 - "Smoking is detrimental to obtaining a solid spinal fusion mass with previous studies demonstrating its association with pseudoarthrosis in patients undergoing spinal fusion. "
5.	Bone Transplantation (Bone Grafting) 04/01/1982 - "The stable plate-osteosynthesis is regarded as the best treatment in combination with an autologous bone grafting in cases of atrophic or defect-pseudarthrosis. " 03/01/2018 - "Advances in surgical techniques and bone grafting have improved fusion; however pseudarthrosis rates remain unacceptably high. " 01/01/2020 - "This study highlights that a continuous external compression is effective in the treatment of non-unions, as it allows consolidation without opening the pseudarthrosis site and without bone grafting while having satisfactory anatomical and functional results." 01/01/1990 - "Clinical and radiological assessment of 8 patients operated because of femoral neck pseudoarthrosis or delayed union proved the pedicle bone grafting to be very useful method, especially in young patients. " 01/01/2023 - "This study aims to evaluate the success of plate augmentation over a retained intramedullary nail (IMN) against exchange nailing performed with autologous bone grafting in oligotrophic and atrophic pseudoarthrosis of the femoral shaft. "