Autologous iliac crest grafting combined with stem cells transplantation in the treatment of early osteonecrosis of the femoral head

doi:10.3969/j.issn.2095-4344.2013.23.026

Abstract

Abstract:

BACKGROUND: There are several existing treatments for osteonecrosis of the femoral head, and early treatment is widely suggested.
OBJECTIVE: To study the curative effect of autologous iliac bone transplantation through decompression and fenestration over the femoral head and neck combined with implantation of peripheral blood hemopoietic stem cells in the treatment of femoral head osteonecrosis at early period.
METHODS: A total of 21 patients with osteonecrosis of the femoral heads (36 hips) were treated with autologous iliac bone transplantation through decompression and fenestration over the femoral head and neck combined with implantation of peripheral blood hemopoietic stem cells from February 2009 to March 2012. Their age ranged 22-50 years (mean 33.6 years). Unilateral head necrosis occurred in six hips, and bilateral head necrosis occurred in 30 hips. The average medical history was 1.4 years ranging from 8 months to 3 years. According to the standard of ARCO staging, seven hips were in the stage Ⅰ, and 29 hips in the stage Ⅱ. The curative effect was analyzed according to clinical symptoms, Harris scores of hip joint function, X-ray film and CT before and after operation.
RESULTS AND CONCLUSION: All the involved 21 patients (36 hips) were followed up for 12-48 months postoperatively. Among them, 29 hips obtained excellent results, showing the pain disappearance and free activities. The femoral head density, trabecular structure and hip joint gap were significantly improved after treatment compared with before treatment. Six hips got relief of clinical symptoms, and one hip had no improvement with exacerbation. The rate of excellent and good effects was 97.2% (35/36). The Harris score increased averagely from preoperative (60.9±5.6) points to postoperative (90.5±5.1) points, with significant differences (P < 0.05). Experimental findings indicate that, bone transplantation through fenestration over the femoral head and neck combined with implantation of peripheral blood hemopoietic stem cells is a promising therapy for the early osteonecrosis of the femoral head, and further studies are required to achieve perfect effects

Key words: stem cells, stem cell clinical practice, stem cell transplantation, hemopoietic stem cells, peripheral blood, osteonecrosis of the femoral head, ischemic, early, iliac bone, autologous, hip joint, Harris score

CLC Number:

R318

Zheng Yue, Yang Xiang-lei, Wang Hui, Li Hui-jie. Autologous iliac crest grafting combined with stem cells transplantation in the treatment of early osteonecrosis of the femoral head[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(23): 4363-4370.

Figures/Tables 4

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