Autologous peripheral blood mononuclear cell transplantation with porous core decompression for treatment of avascular necrosis of the femoral head: an 11-month follow-up evaluation

doi:10.3969/j.issn.2095-4344.2015.01.020

Abstract

Abstract:

BACKGROUND: A large number of clinical trials have found that the number of bone marrow stem cells at the femoral neck and proximal femur in patients with osteonecrosis of the femoral head is significantly reduced, accompanied by decreased activity, which causes a significant decrease in osteogenic capacity that the necrotic bone cannot be effectively repaired after absorption, leading to the collapse of the femoral head.
OBJECTIVE: To probe into the early clinical efficacy of autologous peripheral blood mononuclear cell transplantation with porous core decompression for treatment of avascular necrosis of the femoral head.
METHODS: Forty-five patients with avascular necrosis of the femoral head (49 hips) were enrolled in this study, and underwent autologous peripheral blood mononuclear cell transplantation with porous core decompression. After treatment, pain scores, Harris hip score, scores on the satisfaction of patients were evaluated, as well as X-ray, CT and MRI examinations.
RESULTS AND CONCLUSION: All the patients received a follow-up visit of 11-14 months, averagely (12.5±0.6) months. During the follow-up, there were no complications and serious adverse reactions. Postoperative pain scores and Harris scores were both improved significantly compared with preoperative ones (P < 0.05). At 12 months after treatment, the excellent satisfaction rate was up to 92%. Patient’s MRI low signal region accounting for a percentage of the volume of the femoral head was decreased from (40.1±7.34)% preoperatively to (20.23±5.4)% at 6 months postoperatively, and there was a significant difference (P < 0.05). These findings indicate that autologous peripheral blood mononuclear cell transplantation with porous core decompression for treatment of avascular necrosis of the femoral head has significantly clinical effects at early stage, which can obviously reduce joint pain, improve and restore hip joint function, and delay progression of disease.

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

全文链接：

Key words: Peripheral Blood Stem Cell Transplantation, Femur Head Necrosis, Decompression, Surgical

CLC Number:

R394.2

Wang De-feng, Zhang Xi-shan, Wu Jing-guo, Tao Ru . Autologous peripheral blood mononuclear cell transplantation with porous core decompression for treatment of avascular necrosis of the femoral head: an 11-month follow-up evaluation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(1): 114-118.

Figures/Tables 2

References

[1] 孙伟,李子荣,王佰亮,等.髓芯减压加自体骨髓干细胞移植治疗股骨头坏死的早期随访结果[J].中国组织工程研究与临床康复, 2008,12(12):2231-2234.
[2] 乔巨峰,高飞,汤奇,等. 髓芯减压及自体外周血干细胞移植治疗成人早期股骨头坏死的临床观察[J].中国骨与关节外科,2010, 3(6):458-461.
[3] Gangji V, Hauzeur JP, Schoutens A,et al.Abnormalities in the replicative capacity of osteoblastic cells in the proximal femur of patients with osteonecrosis of the femoral head.J Rheumatol. 2003;30(2):348-351.
[4] 梁红锁,黄克,李林,等. 微创细针多孔髓芯减压联合自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死[J].中国现代药物应用,2014,8(19):456-457.
[5] 孔凡国,李国文,韩松辉. 经皮细针多孔髓芯减压术联合持续动脉内药物灌注治疗早期股骨头缺血性坏死[J].中医正骨,2011, 23(7):39-41.
[6] 中华医学会骨科分会显微修复学组,中国修复重建外科专业委员会骨缺损及骨坏死学组.成人股骨头坏死诊疗标准专家共识[J].中国骨与关节外科,2012,5(2):185-192.
[7] 贾岩波,刘万林,任逸众.激素性股骨头坏死发病机制中细胞凋亡的研究进展[J].中国组织工程研究,2012,16(13): 2444-2450.
[8] 史跃,尹文洲,陈启忠,等.自体骨髓间充质干细胞动脉灌注联合局部注射治疗股骨头坏死[J].中国组织工程研究与临床康复, 2011,15(6):1065-1069.
[9] Gangji V, De Maertelaer V, Hauzeur JP.Autologous bone marrow cell implantation in the treatment of non-traumatic osteonecrosis of the femoral head: Five year follow-up of a prospective controlled study.Bone. 2011;49(5):1005-1009.
[10] 曾建春,樊粤光,曾意荣,等.股骨头髓芯减压植骨腓骨支撑联合自体外周血干细胞移植治疗股骨头坏死初步研究[J].新中医, 2014, 46(8):909-910.
[11] 刘保一,赵德伟.血管内皮细胞生长因子体外修饰骨髓基质干细胞关节镜下回植治疗兔股骨头坏死的研究[J].中华医学杂志，2009,89(37):2629-2733.
[12] 孟祥晖,王万明.股骨头坏死的保头手术治疗[J].中国矫形外科杂志,2011,19(4):308-310.
[13] Lavernia CJ, Sierra RJ.Core decompression in atraumatic osteonecrosis of the hip.J Arthroplasty. 2000;15(2):171-178.
[14] Aigner N, Schneider W, Eberl V,et al.Core decompression in early stages of femoral head osteonecrosis--an MRI-controlled study.Int Orthop. 2002;26(1):31-35.
[15] Wang BL, Sun W, Shi ZC,et al.Decreased proliferation of mesenchymal stem cells in corticosteroid-induced osteonecrosis of femoral head.Orthopedics. 2008;31(5):444.
[16] 李忠,陈歌,王治,等.髓芯减压复合自体骨髓间充质干细胞移植治疗股骨头缺血性坏死[J].中国矫形外科杂志,2012,20(5): 411-414.
[17] 梁红锁,黄克,李林,等.钽棒植入联合自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死[J].医学理论与实践,2014,27(19): 2534-2535.
[18] 李杨,冯世庆.早期股骨头缺血性坏死治疗：髓芯减压并钽棒优于并植骨[J].中国组织工程研究,2014,18(5):815-820.
[19] 申文龙,杜丽,张辉,等.髓芯减压植骨自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死[J].中国骨与关节损伤杂志,2011, 26(4):353-354.
[20] 唐烽明,王景贵,赵栋,等.激素药源性股骨头坏死及骨质疏松49例中期分析[J].中国骨与关节损伤杂志,2012,27(2):106-108.
[21] 方志,陈曦,刘树平.髓芯减压结合自体皮质支撑骨及松质颗粒骨植骨治疗成人股骨头缺血性坏死[J].中国修复重建外科杂志, 2010,24(3):266-269.
[22] 周炎.髓芯减压植骨术治疗早期股骨头缺血性坏死的临床疗效观察[D].武汉:湖北中医学院,2009.
[23] 陶家安.髓芯减压配合中药分型治疗股骨头缺血性坏死[J].中国民族民间医药,2011,20(16):89,93.
[24] 李富新.钽棒植入治疗早期股骨头坏死的临床疗效观察[J].当代医学,2011,17(19):55-57.
[25] 田庆海.股骨头缺血性坏死的临床治疗观察[J].中国实用医药，2011,6(23):74-75.
[26] 胡跃春,曾秋华,刘晓明.早期股骨头缺血性坏死的MRI诊断[J].罕少疾病杂志,2011,18(3):44-45.
[27] Dailiana ZH, Toth AP, Gunneson E,et al.Free vascularized fibular grafting following failed core decompression for femoral head osteonecrosis.J Arthroplasty. 2007;22(5): 679-688.
[28] 康鹏德,裴福兴,杨静,等.骨髓脂肪细胞向骨细胞的转分化[J].中国组织工程研究与临床康复,2011,15(1):17-22.