Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (6): 1065-1069.doi: 10.3969/j.issn.1673-8225.2011.06.025

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Arterial perfusion combined with regional injection of autologous bone marrow mesenchymal stem cells for femoral head necrosis 

Shi Yue1, Yin Wen-zhou2, Chen Qi-zhong3, Wang An-ming1, Liu Jun-quan4, Liu Hong-bin5, Gao Cong-jing1   

  1. 1Department of Interventional Radiology, the 97th Hospital of Chinese PLA, Xuzhou  221004, Jiangsu Province, China
    2Department of Interventional Radiology, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou  221003, Jiangsu Province, China
    3Department of Emergency, the 97th Hospital of Chinese PLA, Xuzhou  221004, Jiangsu Province, China
    4Department of Medical Laboratory, the 97th Hospital of Chinese PLA, Xuzhou  221004, Jiangsu Province, China
    5Department of Orthopedics, the 97th Hospital of Chinese PLA, Xuzhou  221004, Jiangsu Province, China
  • Received:2010-09-03 Revised:2010-10-18 Online:2011-02-05 Published:2011-02-05
  • About author:Shi Yue, Associate chief physician, Department of Interventional Radiology, the 97th Hospital of Chinese PLA, Xuzhou 221004, Jiangsu Province, China shiyue66@126.com

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Abstract:

BACKGROUND: Cellular level studies have demonstrated that the proliferative ability of osteoblasts at the proximal end of the femur of patients with femoral head avascular necrosis was decreased, and the number of mesenchymal stem cells (MSCs) was diminished in the femoral head. Therefore, the treatment of femoral head avascular necrosis was done simultaneously when the blood supple was improved. Seed cells with osteogenic ability should be supplemented in the local necrotic region.
OBJECTIVE: To observe clinical curative effect of autologous bone marrow MSCs (BMSCs) arterial perfusion in combination with interventional therapy of local puncture injection for treatment of femoral head avascular necrosis.
METHODS: In 32 patients with femoral head avascular necrosis in the research group, the catheter was placed on the femoral head to support the artery using seldinger technique via percutaneous-femoral artery puncture. Urokinase 30×104 U and papaverine 30 mg were perfused. 10 mL BMSCs suspension was perfused via the medial femoral circumflex artery. 10 mL BMSCs suspension was infused via multiple points of percutaneous puncture at the necrotic region of the femoral head. The number of BMSCs was 2×107-2×108. The 34 patients with femoral head avascular necrosis of the concurrent control group were compared using interventional therapy of artery thrombolysis. The second and third interventional therapy was performed with an interval of 2 and 4 weeks, three times as a course, in both groups.
RESULTS AND COMCLUSION: Stenosis, occlusion and revascularization were observed in the femoral head and neck regions of 32 patients of the research group. The vessel dying region of the femoral head was obviously enlarged. Necrotic region was gradually shortened in 29 cases. Following treatment, the improvement degree of range of motion was better in the research group than the control group. The effective rate of pain easement was 93.8%, and the clinical recovery rate was 84.4% in the research group, which were greater compared with the control group. Results demonstrated that perfusion of autologous BMSCs in combination with interventional therapy of multiple injection of percutaneous puncture for treatment of femoral head avascular necrosis following artery thrombolysis can elevate curative effect, pain release and improve joint function.

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