Treatment of nontraumatic osteonecrosis of the femoral head with the implantation of core decompression and concentrated autologous bone marrow containing ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-07-21

AUTHORS

Bai-Liang Wang, Wei Sun, Zhen-Cai Shi, Nian-Fei Zhang, De-Bo Yue, Wan-Shou Guo, Shu-Qing Xu, Jin-Ning Lou, Zi-Rong Li

ABSTRACT

BackgroundSince self-limited repair ability of the necrotic lesion may be a cause for failure of the technique, the possibility has been raised that bone marrow mononuclear cells (BMMCs) containing BMSCs implanted into a necrotic lesion of the femoral head with core decompression (CD) may be of benefit in the treatment of this condition. For this reason, we studied the implantation of the concentrated autologous bone marrow containing mononuclear cells in necrotic lesion of the femoral head to determine the effect of the method.MethodsThe study included 45 patients (59 hips, 9 females, 36 males; mean age 37.5 years, range 16–56 years) with stages I–IIIA nontraumatic avascular necrosis of the femoral head according to the system of the Association Research Circulation Osseous. Concentrated bone marrow (30–50 ml) containing mononuclear cells has been gained from autologous bone marrow (100–180 ml) obtained from the iliac crest of patient with the cell processor system. Concentrated bone marrow was injected through a CD channel into the femoral head. The outcome was determined by the changes in the Harris hip score, by progression in radiographic stages, and by the need for hip replacement. The mean follow-up was 27.6 months (range 12–40 months).ResultsPre- and post-operative evaluations showed that the mean Harris hip score increased from 71 to 83. Clinically, the overall success is 79.7%, and hip replacement was done in 7 of the 59 hips (11.9%). Radiologically, 14 of the 59 hips exhibited femoral head collapse or narrowing of the coxofemoral joint space, and the overall failure rate is 23.7%. The number of BMMCs increased from 12.2 ± 3.2 × 106/ml to 35.2 ± 12 × 106/ml between pre-concentration and post-concentration.ConclusionThe concentrated autologous bone marrow containing mononuclear cells implantation relieves hip pain, prevents the progression of osteonecrosis. Therefore, it may be the treatment of choice particularly in stages I–II nontraumatic osteonecrosis of the femoral head. More... »

PAGES

859-865

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00402-009-0939-0

DOI

http://dx.doi.org/10.1007/s00402-009-0939-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1043724644

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19621230


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