Autologous Concentrated Bone Marrow Grafting for the Treatment of Osteonecrosis of the Humeral Head: A Report of Five Shoulders in Four Cases

Makihara, Takeshi; Yoshioka, Tomokazu; Sugaya, Hisashi; Yamazaki, Masashi; Mishima, Hajime

doi:10.1155/2017/4898057

Cited by 12 publications

(9 citation statements)

References 30 publications

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“…Six year post-operative outcomes of proceeding concentrated autologous bone marrow aspirate transplantation (CABMAT) resulted in the successful prevention of femoral head collapse [169]. Clinical evaluation of the spared joints in autologous concentrated bone marrow grafting conducted on four patients affected by advanced osteonecrosis resulted in recovery and improved motion [170]. The yearlong human model study by De Riu et al demonstrated efficacy of bone marrow nucleated concentrate (BMNc) in patients with degenerative temporomandibular joint disorders (TMDs).…”

Section: Bone Marrow Mononuclear Cells and Bone Marrow Concentratementioning

confidence: 99%

Bone Regeneration, Reconstruction and Use of Osteogenic Cells; from Basic Knowledge, Animal Models to Clinical Trials

Hutchings

Moncrieff

Dompe

et al. 2020

JCM

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The deterioration of the human skeleton’s capacity for self-renewal occurs naturally with age. Osteoporosis affects millions worldwide, with current treatments including pharmaceutical agents that target bone formation and/or resorption. Nevertheless, these clinical approaches often result in long-term side effects, with better alternatives being constantly researched. Mesenchymal stem cells (MSCs) derived from bone marrow and adipose tissue are known to hold therapeutic value for the treatment of a variety of bone diseases. The following review summarizes the latest studies and clinical trials related to the use of MSCs, both individually and combined with other methods, in the treatment of a variety of conditions related to skeletal health. For example, some of the most recent works noted the advantage of bone grafts based on biomimetic scaffolds combined with MSC and growth factor delivery, with a greatly increased regeneration rate and minimized side effects for patients. This review also highlights the continuing research into the mechanisms underlying bone homeostasis, including the key transcription factors and signalling pathways responsible for regulating the differentiation of osteoblast lineage. Paracrine factors and specific miRNAs are also believed to play a part in MSC differentiation. Furthering the understanding of the specific mechanisms of cellular signalling in skeletal remodelling is key to incorporating new and effective treatment methods for bone disease.

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Section: Bone Marrow Mononuclear Cells and Bone Marrow Concentratementioning

confidence: 99%

Bone Regeneration, Reconstruction and Use of Osteogenic Cells; from Basic Knowledge, Animal Models to Clinical Trials

Hutchings

Moncrieff

Dompe

et al. 2020

JCM

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“…30 Bone grafting, either simple autologous grafting, strut bone graft or vascularised bone graft are complex procedures with increased morbidity and variable results. 31,32 It remains unclear as to the most effective joint sparing treatment of osteonecrosis. The natural history of conservatively treated advanced osteonecrosis of the humeral head is poor.…”

Section: Discussionmentioning

confidence: 99%

Dysbaric osteonecrosis in technical divers: The new ‘at-risk’ group?

Coleman¹,

Davis

2020

Diving Hyperb Med

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Introduction: Dysbaric osteonecrosis (DON) in people working under increased atmospheric pressure is well documented. It is generally less common in military and commercial divers than in caisson workers, except in some high-risk groups, such as in many indigenous diving industries where workers have little or no understanding of decompression principles. With the increasing popularity within the recreational diving community of deep air and mixed-gas decompression diving (‘technical diving’), it is likely that diving physicians may see an increase in the prevalence of DON in this group in the future. Methods: The case report is presented of a technical diving instructor, with a 30-year history of deep diving, who developed bilateral humeral head DON and required a right shoulder hemi-arthroplasty. A focused literature search was also undertaken to identify published cases of DON in recreational divers. Results: The frequency, duration and depth of exposure to pressure, inadequate decompression, the occurrence of DCS and increasing age have been common features associated with DON in both divers and caisson workers. Many of these features were present in this technical diver. Conclusions: Whilst DON is uncommon in recreational air scuba divers, all the above risk factors are present to a greater degree in technical diving. It is suggested that medical review for DON is merited from time to time in this potentially high-risk group of recreational divers.

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“…Previous systemic reviews into the management of gleno-humeral ON are limited [5]. A variety of different surgical techniques have been described to deliver improved clinical outcomes for patients with symptomatic ON by a number of authors [1,3,8,9,14,19,21]. These include core decompression, autologous concentrated bone marrow grafting, hemiarthroplasty, total shoulder arthroplasty and reverse shoulder arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

The staged management of gleno-humeral joint osteonecrosis in patients with haematological-induced disease—a cohort review

Colegate-Stone

Aggarwal

Karuppaiah

et al. 2018

International Orthopaedics (SICOT)

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Purpose A formalised, universally accepted, radiological staging system of gleno-humeral joint osteonecrosis (ON) is lacking. Consequently, there is absence of a standardised management strategy. The aim is to propose a simple radiological staging system of gleno-humeral joint ON based on principles of the Association Research Circulation Osseous (ARCO) Society and review of clinical practice. Methods A radiographic and clinical review of 45 patients with haematological-induced gleno-humeral ON was performed. The related management plans were analysed and categorised. Results Analysis divided the disease into stages 0-4. Non-interventional management was the first-line treatment in stages 1-2. If unsuccessful, arthroscopic core decompression was performed. Patients with stages 3-4 were initially managed conservatively. If unsuccessful, in younger patients, arthroscopic joint debridement and capsular release was trialled. In older patients, or where this approach failed, shoulder arthroplasty was advised. Conclusion The simple radiological classification assessed is useful to the provision of a standardised staged management strategy of gleno-humeral ON.

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Autologous Concentrated Bone Marrow Grafting for the Treatment of Osteonecrosis of the Humeral Head: A Report of Five Shoulders in Four Cases

Cited by 12 publications

References 30 publications

Bone Regeneration, Reconstruction and Use of Osteogenic Cells; from Basic Knowledge, Animal Models to Clinical Trials

Bone Regeneration, Reconstruction and Use of Osteogenic Cells; from Basic Knowledge, Animal Models to Clinical Trials

Dysbaric osteonecrosis in technical divers: The new ‘at-risk’ group?

The staged management of gleno-humeral joint osteonecrosis in patients with haematological-induced disease—a cohort review

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