Effect of platelet-rich plasma with bioceramic system on the treatment of ARCO stage II osteonecrosis of the femoral head

doi:10.12307/2022.588

Abstract

Abstract: BACKGROUND: The bioceramic system can guide the blood supply near the greater trochanter and the femoral neck to the femoral head through the porous structure, thereby promoting the repair of osteonecrosis and partially restoring the mechanical properties of the femoral head and neck. It has been widely used in the treatment of early osteonecrosis of the femoral head. Platelet-rich plasma has a certain positive effect on the treatment of early osteonecrosis of the femoral head.
OBJECTIVE: To investigate the clinical effect of platelet-rich plasma with the bioceramic system on the treatment of Association Research Circulation Osseous (ARCO) stage II osteonecrosis of the femoral head.
METHODS: Sixty patients with ARCO stage II osteonecrosis of the femoral head who were admitted to the Second People’s Hospital of Jiaozuo City from July 2016 to May 2020 were randomly divided into two groups (n=30 per group): a control group and a test group. Patients in the control group received bioceramic system implantation. Patients in the test group received autologous platelet-rich plasma with bioceramic system implantation. After the treatment, the anteroposterior X-ray film of the affected limb was regularly reviewed to determine the morphological changes of the femoral head; and the severity of pain and hip joint function of patients in the two groups were compared.
RESULTS AND CONCLUSION: Both groups of patients were followed up for 12 months. There was one patient in the test group and five patients in the control group who developed femoral head collapse. After hip arthroplasty, these six patients were excluded from the trial. Finally 54 patients were included in the result analysis. During the follow-up period, 54 patients had no material host reaction. In the test group, the visual analogue scale scores were all lower than those in the control group at 3, 6, and 12 months after treatment (P < 0.05), and the hip function scores were all higher than those in the control group at 3, 6, and 12 months after treatment (P < 0.05). To conclude, platelet-rich plasma combined with the bioceramic system is a minimally invasive treatment for ARCO stage II osteonecrosis of the femoral head, which can promote the repair of osteonecrosis and effectively improve the hip pain and joint function in such patients.

Key words: platelet-rich plasma, implant, osteonecrosis of the femoral head, bioceramics, core decompression, bone graft, hip joint function

CLC Number:

Chai Le, Ding Xiao, Wang Bin, Chen Xu, Guo Jiarui, Zhu Guangpu, Yu Jinwei . Effect of platelet-rich plasma with bioceramic system on the treatment of ARCO stage II osteonecrosis of the femoral head[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(15): 2347-2351.

Figures/Tables 6

References

[1] MA YW, JIANG DL, ZHANG D, et al. Radial Extracorporeal Shock Wave Therapy in a Person With Advanced Osteonecrosis of the Femoral Head. Am J Phys Med Rehabil. 2016;95(9):e133-139.
[2] OHZONO K. Natural history of nontraumatic avascular necrosis of the femoral head. J Bone Joint Surg Br. 1991;73(1):68-72.
[3] 姜良斌,肖伯莲,刘松,等.富血小板血浆联合高位股骨头颈开窗植骨支撑术治疗早期股骨头坏死的研究[J].中国临床解剖学杂志, 2018,36(4):93-96.
[4] SHULER MS, ROOKS MD, ROBERSON JR. Porous tantalum implant in early osteonecrosis of the hip: preliminary report on operative, survival, and outcomes results. J Arthroplasty. 2007;22(1):26-31.
[5] 鲁亚杰,王臻,卢霄,等.生物陶瓷系统微创治疗ARCOⅡ,Ⅲ期股骨头坏死[J].中国修复重建外科杂志,2019,33(10):96-103.
[6] TONG S, YIN J, LIU J. Platelet-rich plasma has beneficial effects in mice with osteonecrosis of the femoral head by promoting angiogenesis. Exp Ther Med. 2018;15(2):1781-1788.
[7] 李子荣.股骨头坏死临床诊疗规范[J].中华骨与关节外科杂志,2015, 8(1):1-6.
[8] DOMITROVIC R, RASHED K, CVIJANOVIC O, et al. Myricitrin exhibits antioxidant, anti-inflammatory and antifibrotic activity in carbon tetrachloride-intoxicated mice. Chem Biol Interact. 2015;230:21-29.
[9] WANG D, WANG G, LIU M, et al. A novel animal model of osteonecrosis of the femoral head induced using a magnetic resonance imaging-guided argon-helium cryotherapy system. Exp Ther Med. 2014;7(6):1525.
[10] ALDRIDGE JM, URBANIAK JR. Avascular necrosis of the femoral head: etiology, pathophysiology, classification, and current treatment guidelines. Am J Orthop. 2004;33(7):327-332.
[11] MONT MA, CARBONE JJ, FAIRBANK AC. Core decompression versus nonoperative management for osteonecrosis of the hip. Clin Orthop Relat Res. 1996;324(324):169-178.
[12] ZALAVRAS CG, LIEBERMAN JR. Osteonecrosis of the femoral head: evaluation and treatment. J Am Acad Orthop Surg. 2015;23(7):69-70.
[13] BOSWELL SG, COLE BJ, SUNDMAN EA, et al. Platelet-Rich Plasma: A Milieu of Bioactive Factors. Arthroscopy. 2012;28(3):429-439.
[14] VANNINI F, MATTEO BD, FILARDO G. Platelet-rich plasma to treat ankle cartilage pathology - from translational potential to clinical evidence: a systematic review. J Exp Orthop. 2015;2(1):2.
[15] AHMED M, REFFAT S, HASSAN A, et al. Platelet-Rich Plasma for the Treatment of Clean Diabetic Foot Ulcers. Ann Vasc Surg. 2016;38:206-211.
[16] ORYAN A, ALIDADI S, MOSHIRI A. Platelet-rich plasma for bone healing and regeneration. Expert Opin Biol Ther. 2015;16(2):213-232.
[17] WANG B, GENG Q, HU J, et al. Platelet-rich plasma reduces skin flap inflammatory cells infiltration and improves survival rates through induction of angiogenesis: An experiment in rabbits. J Plast Surg Hand Surg. 2016;50:239-245.
[18] LIEBERMAN JR, ENGSTROM SM, MENEGHINI RM, et al. Which factors influence preservation of the osteonecrotic femoral head? Clin Orthop Relat Res. 2012;470(2):525-534.
[19] ARBAB D, KÖNIG DP. Atraumatic Femoral Head Necrosis in Adults. Dtsch Arztebl Int. 2016;113(3):31-38.
[20] LIN D, WANG L, YU Z, et al. Lantern-shaped screw loaded with autologous bone for treating osteonecrosis of the femoral head. BMC Musculoskelet Disord. 2018;19(1):318.
[21] PEDERSEN DR, BROWN TD, POGGIE RA. Finite element characterization of a porous tantalum material for treatment of avascular necrosis. Trans Orthop Res Soc. 1997;22:598.
[22] BOBYN JD, STACKPOOL GJ, HACKING SA, et al. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg Br. 1999;81(5):907.
[23] KATO H, NAKAMURA T, NISHIGUCHI S, et al. Bonding of alkali- and heat-treated tantalum implants to bone. J Biomed Mater Res. 2015;53(1): 28-35.
[24] 薄斌,王常勇,郭希民,等.骨髓间质干细胞复合多孔磷酸钙陶瓷修复兔颅骨缺损的研究[J].中国修复重建外科杂志,2003,17(4): 335-338.
[25] 潘红娟,汪丽,刘铁梅.富血小板血浆成分及其作用的研究新进展[J].中国输血杂志,2016,29(12):1408-1412.
[26] VANNINI F, MATTEO BD, FILARDO G. Platelet-rich plasma to treat ankle cartilage pathology - from translational potential to clinical evidence: a systematic review. J Exp Orthop. 2015;2(1):2.
[27] HODGE JA, KAWABATA TT, KRISHNASWAMI S, et al. The mechanism of action of tofacitinib - an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. Clin Exp Rheumatol. 2016;34(2):318.
[28] XU HH, LI SM, FANG L, et al. Platelet-rich plasma promotes bone formation, restrains adipogenesis and accelerates vascularization to relieve steroids-induced osteonecrosis of the femoral head. Platelets. 2021;32(7):950-959.
[29] XIAN H, LUO D, WANG L, et al. Platelet-Rich Plasma-Incorporated Autologous Granular Bone Grafts Improve Outcomes of Post-Traumatic Osteonecrosis of the Femoral Head. J Arthroplasty. 2019;35(2):1-6.
[30] 陈冬冬,鲁超,宇文星,等.富血小板血浆联合髓芯减压植骨术治疗ARCOⅡ期非创伤性股骨头坏死[J]. 中国骨伤,2020,33(11):63-67.