Stage-Related Results in Treatment of Hip Osteonecrosis with Core-Decompression and Autologous Mesenchymal Stem Cells
Acta Orthop. Belg., 2015, 81, 406-412 ORIGINAL STUDY Stage-related results in treatment of hip osteonecrosis with core-decompression and autologous mesenchymal stem cells Pietro PERSIANI, Claudia DE CRISTO, Jole GRACI, Giovanni NOIA, Michele GURZÌ, Ciro VILLANI From Universitary Department of Anatomic, Histologic, Forensic and Locomotor Apparatus Sciences, Section of Locomotor Apparatus Sciences, Policlinico Umberto I, Sapienza University of Rome Our aim is to analyse the clinical outcome of a series thetic hip replacement. Therapy with glucocorti- of patients affected by avascular necrosis of the femo- coids and alcohol abuse are some of the main known ral head and treated with core-decompression tech- causative factors (21). Several pathophysiological nique and autologous stromal cells of the bone mechanisms were formulated about this pathology, marrow. including fat emboli, microvascular occlusion of We enrolled in our study 29 patients with 31 hips in epiphysis vessels and micro fracture of trabecular total affected by avascular necrosis of the femoral 13,18 head. bone ( ). An early diagnosis and a continuous The clinical and radiological outcome has been monitoring of patients with risk factors (corticoste- assessed through self-administered questionnaires roids therapy, alcoholism, or irradiated patients) are (HHS, VAS and SF12) X-ray and Magnetic Reso- very important in order to highlight the AVNFH nance. typical alteration as early as possible. Of all the examined hips, 25 showed a relief of the The treatment of osteonecrosis is one of the most symptoms and a resolution of the osteonecrosis, 11 of controversial subjects in the orthopaedic literature. these were at Stage I and 14 at Stage II.
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