Authors: BaiLiang Wang Wei Sun ZhenCai Shi NianFei Zhang DeBo Yue WanShou Guo ShuQing Xu JinNing Lou ZiRong Li
Publish Date: 2009/07/21
Volume: 130, Issue: 7, Pages: 859-865
Abstract
Since selflimited 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 methodThe study included 45 patients 59 hips 9 females 36 males mean age 375 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 followup was 276 months range 12–40 monthsPre and postoperative evaluations showed that the mean Harris hip score increased from 71 to 83 Clinically the overall success is 797 and hip replacement was done in 7 of the 59 hips 119 Radiologically 14 of the 59 hips exhibited femoral head collapse or narrowing of the coxofemoral joint space and the overall failure rate is 237 The number of BMMCs increased from 122 ± 32 × 106/ml to 352 ± 12 × 106/ml between preconcentration and postconcentrationThe 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
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