Mid-Term Comparative Outcomes of Autologous Bone-Marrow Concentration to Treat Osteonecrosis of the Femoral Head in Standard Practice

Cruz-Pardos, Ana; García-Rey, Eduardo; Ortega-Chamarro, J.; Duran-Manrique, David; Gómez‐Barrena, Enrique

doi:10.5301/hipint.5000366

Cited by 19 publications

(36 citation statements)

References 25 publications

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“…Among comparative studies, seven were retrospective comparative studies [13,15,17,25,34,54]: six missed to find any significant difference between treatment and control groups, analyzing clinical scores, radiologic outcomes and failures, and only one [27] reported significantly increased clinical and radiological scores, with fewer failures. Two level II prospective comparative studies [11,39] were found in the literature.…”

Section: Resultsmentioning

confidence: 99%

Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis

Andriolo

Merli²,

Tobar³

et al. 2018

International Orthopaedics (SICOT)

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Section: Resultsmentioning

confidence: 99%

Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis

Andriolo

Merli²,

Tobar³

et al. 2018

International Orthopaedics (SICOT)

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“…ONFH is a painful and debilitating condition, which affects both middle-aged and young adults [ 3 , 22 – 24 ]. The pathogenesis and etiology of ONFH are complex and no single factor can fully explain how the blood supply to the femoral head is damaged, culminating in the death of hematopoietic cells, bone cells, and adipocytes [ 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

Bone-strengthening pill (BSP) promotes bone cell and chondrocyte repair, and the clinical and experimental study of BSP in the treatment of osteonecrosis of the femoral head

Wang

Jin

et al. 2017

Oncotarget

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About 1 in 3 people suffer from bone and joint disease, which is a disease of bone and cartilage cells. Osteonecrosis of the femoral head (ONFH) is a typical example of bone and joint disease involving bone cell necrosis. Osteonecrosis of the femoral head leads to the occurrence of premature osteoarthritis of the hip and collapse of the cartilage cells, and there is currently no effective drug treatment available. In order to study the effects of “bone-strengthening pill” (BSP) on the repair of bone and cartilage cells, we investigated the potential effects of the herbal mixture BSP in an animal model of avascular necrosis of the femoral head and in patients. Results showed that 90% of rats injected with prednisone developed ONFH, whereas BSP administration prevented ONFH development in 70% of prednisone-injected rats. We evaluated the constituents of BSP by HPLC fingerprinting. We also evaluated the clinical efficacy of BSP in a double-blind, randomized, controlled trial of 300 patients with ONFH. The response rate was found to be higher in the treatment group than in the control group, with a response rate of 82% in the treatment group. Treatment with BSP also significantly reduced pain, improved hip function, reduced lameness, and improved pathology by X-ray and MRI analysis, compared with patients who did not receive BSP. These results suggest that BSP treatment inhibits and reverses necrosis of the femoral head bone cells and cartilage cells to repair the femoral head, promote the repair of bone and cartilage diseases.

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“…Harris Hip Score: A total of 11 trials 29 , 31 , 32 , 35 - 39 , 41 , 42 , 44 , 48 , 48 reported HHS postoperatively during follow-up. Due to the lack of standard deviation (SD) data for four studies, 30 , 38 , 40 , 42 we only analyzed seven studies 32 , 33 , 36 , 37 , 43 , 45 , 49 involving 474 hips (Intervention = 256, Control = 218).…”

Section: Primary Outcome Measuresmentioning

confidence: 99%

Section: Primary Outcome Measuresmentioning

confidence: 99%

“…Collapse of the femoral head: A total of 14 trials 30 - 34 , 35 , 37 – 39 - 46 , 41 - 46 enrolling a total of 1,155 hips (Intervention = 615, Control = 540) mentioned the number of collapse cases of the femoral head. According to the different intervention measures, we divided the studies into three subgroups (cell therapy = 9, 31 , 34 , 35 , 38 , 39 , 41 , 43 , 44 , 46 bone grafting = 4, 30 , 32 , 37 , 42 and biological materials = 1 45 ). Heterogeneity existed between studies of cell therapy (I 2 = 68%, p = 0.001, chi-squared test) and the bone grafting group (I 2 = 56%, p = 0.080, chi-squared test) ( Figure 5 ); therefore, we performed sensitivity analysis by omitting each study but did not identify the source of heterogeneity.…”

Section: Primary Outcome Measuresmentioning

confidence: 99%

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Comparison of cell therapy and other novel adjunctive therapies combined with core decompression for the treatment of osteonecrosis of the femoral head

Zhu

Zhang

Chen

et al. 2021

Bone & Joint Research

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Aims The value of core decompression (CD) in the treatment of osteonecrosis of the femoral head (ONFH) remains controversial. We conducted a systematic review and meta-analysis to evaluate whether CD combined with other treatments could improve the clinical and radiological outcomes of ONFH patients compared with CD alone. Methods We searched the PubMed, Embase, Web of Science, and Cochrane Library databases until June 2020. All randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing CD alone and CD combined with other measures (CD + cell therapy, CD + bone grafting, CD + porous tantalum rod, etc.) for the treatment of ONFH were considered eligible for inclusion. The primary outcomes of interest were Harris Hip Score (HHS), ONFH stage progression, structural failure (collapse) of the femoral head, and conversion to total hip arthroplasty (THA). The pooled data were analyzed using Review Manager 5.3 software. Results A total of 20 studies with 2,123 hips were included (CD alone = 768, CD combined with other treatments = 1,355). The combination of CD with other therapeutic interventions resulted in a higher HHS (mean difference (MD) = 6.46, 95% confidence interval (CI) = 2.10 to 10.83, p = 0.004) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (MD = −10.92, 95% CI = -21.41 to -4.03, p = 0.040) and a lower visual analogue scale (VAS) score (MD = −0.99, 95% CI = -1.56 to -0.42, p < 0.001) than CD alone. For the rates of disease stage progression, 91 (20%) progressed in the intervention group compared to 146 (36%) in the control group (odds ratio (OR) = 0.32, 95% CI = 0.16 to 0.64, p = 0.001). In addition, the intervention group had a more significant advantage in delaying femoral head progression to the collapsed stage (OR = 0.32, 95% CI = 0.17 to 0.61, p < 0.001) and reducing the odds of conversion to THA (OR = 0.35, 95% CI = 0.23 to 0.55, p < 0.001) compared to the control group. There were no serious adverse events in either group. Subgroup analysis showed that the addition of cell therapy significantly improved clinical and radiological outcomes compared to CD alone, and this approach appeared to be more effective than other therapies, particularly in precollapse (stage I to II) ONFH patients. Conclusion There was marked heterogeneity in the studies. There is a trend towards improved clinical outcomes with the addition of stem cell therapy to CD. Cite this article: Bone Joint Res 2021;10(7):445–458.

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Mid-Term Comparative Outcomes of Autologous Bone-Marrow Concentration to Treat Osteonecrosis of the Femoral Head in Standard Practice

Cited by 19 publications

References 25 publications

Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis

Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis

Bone-strengthening pill (BSP) promotes bone cell and chondrocyte repair, and the clinical and experimental study of BSP in the treatment of osteonecrosis of the femoral head

Comparison of cell therapy and other novel adjunctive therapies combined with core decompression for the treatment of osteonecrosis of the femoral head

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