Assessment Autologous Bone Marrow Derived Cells with Core Decompression as Treatment Option for Avascular Necrosis of the Femoral H

Abstract

Background:  Avascular  necrosis  of  the  femoral  head  (AVN)  is  a progressive  pathological  process  resulting  from  disruption  of  blood supply to the femoral head and elevation of intraosseous pressure. Early stage AVN can be managed by various techniques, the results have been disappointing, total hip arthroplasty is frequently the only durable option for  pain  relief  and  restoration  of  function.  The  newer  treatment modalities include using high stem cell concentration in the vicinity of the  necrosed  tissue  with  core  decompression  to  prevent  disease progression. Patients  and methods: A single armed study done from October 2017 till February 2019, the total number of patients was 10, (5 Female 5 male). Etiology include corticosteroids use, systemic lupus erythematosus, sickle cell disease and idiopathic. The age of the patients range from 25-57  years. The procedure includes core decompression with autologous bone marrow derived mononuclear cell injection inside the hip joint space. Results: The results showed improvement in the Harris  hip  score  from  48.7±6.6  to  88.00±4.6  (p＜0.001)  in  seven patients.  With  radiological  proof  by  magnetic  resonance  imaging. Conclusions:  This  single  arm  short  term  study  showed  that  core decompression with autologous bone marrow derived cell therapy is safe and effective method and it is a form of minimal manipulative treatment and merits such treatment in larger and longer term study.