Osteonecrosis of the femoral head with subchondral collapse

Piuzzi, Nicolás S.; Anis, Hiba K.; Muschler, George F.

doi:10.3949/ccjm.86a.19004

“…2 Yueyang Traditional Chinese Medicine Hospital, Hunan, China. 3 Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu, China. 4 Department of Orthopedics, Massachusetts General Hospital, Boston, MA, USA.…”

Section: Ethics Approval and Consent To Participatementioning

confidence: 99%

“…of patients [1]. The course of this disease is progressive, and the arthritis severity gradually increases [2] until patients with late-stage ONFH require total hip arthroplasty (THA) [3]. In clinical practice, it is challenging to determine how to prevent the progression of early-stage ONFH or to completely repair the necrotic areas to avoid THA.…”

mentioning

confidence: 99%

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Wu

¹

,

Sun

²

,

Liu

³

et al. 2019

Preprint

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Background: Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients. Repair of the necrotic area is key to successful treatment. Currently, the combination of stem cell transplantation and decompression is used clinically to promote the repair of necrotic areas based on the characteristics of stem cells. However, a considerable number of patients do not achieve a satisfactory outcome in terms of repair of the femoral head necrotic area, and it is very important to determine the reasons for the poor curative effect. The aim of this study was to investigate the correlation between stem cell viability and the repair efficacy of stem cell therapy combined with core decompression for early-stage ONFH. Methods: A total of 30 patients with idiopathic ONFH underwent core decompression combined with autologous stem cell transplantation. The Harris hip score (HHS) and difference in necrosis area before and after surgery were measured. The mean repair ratio was set as the threshold to divide the patients into group A (ratio above the mean) and group B (ratio below the mean). The ultrastructure, proliferative capacity, and multidirectional differentiation ability were compared between the groups. Results : At 9 months after surgery, the HHS and magnetic resonance imaging (MRI) findings improved by varying degrees. Based on the mean repair ratio of (62.2 ± 27.0)%, the threshold for dividing the patients into groups A and B was set to 62.2%. Better repair (group A) was associated with more rapid proliferation and a healthier ultrastructure. The cells in group A showed stronger specific staining signifying osteogenic and chondrogenic differentiation; alkaline phosphatase (ALP) activity, an indicator of osteogenic differentiation, was higher in group A than in group B (OD, 2.39 ± 0.44 and 1.85 ± 0.52; p < 0.05). Conclusions: The quality of implanted stem cells is closely related to treatment efficacy and determines whether the defective self-repair in the necrotic area can be corrected to enhance repair and thus achieve the desired therapeutic outcome.

show abstract

“…Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients [1]. The course of this disease is progressive, and the arthritis severity gradually increases [2] until patients with late-stage ONFH require total hip arthroplasty (THA) [3]. In clinical practice, it is challenging to determine how to prevent the progression of early-stage ONFH or to completely repair the necrotic areas to avoid THA.…”

Section: Introductionmentioning

confidence: 99%

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Wu

¹

,

Sun

²

,

Liu

³

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background: Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients. Repair of the necrotic area is key to successful treatment. Currently, the combination of stem cell transplantation and decompression is used clinically to promote the repair of necrotic areas based on the characteristics of stem cells. However, a considerable number of patients do not achieve a satisfactory outcome in terms of repair of the femoral head necrotic area, and it is very important to determine the reasons for the poor curative effect. The aim of this study was to investigate the correlation between stem cell viability and the repair efficacy of stem cell therapy combined with core decompression for early-stage ONFH.Methods: A total of 30 patients with idiopathic ONFH underwent core decompression combined with autologous stem cell transplantation. The Harris hip score (HHS) and difference in necrosis area before and after surgery were measured. The mean repair ratio was set as the threshold to divide the patients into group A (ratio above the mean) and group B (ratio below the mean). The ultrastructure, proliferative capacity, and multidirectional differentiation ability were compared between the groups.Results: At 9 months after surgery, the HHS and magnetic resonance imaging (MRI) findings improved by varying degrees. Based on the mean repair ratio of (62.2 ± 27.0)%, the threshold for dividing the patients into groups A and B was set to 62.2%. Better repair (group A) was associated with more rapid proliferation and a healthier ultrastructure. The cells in group A showed stronger specific staining signifying osteogenic and chondrogenic differentiation; alkaline phosphatase (ALP) activity, an indicator of osteogenic differentiation, was higher in group A than in group B (OD, 2.39 ± 0.44 and 1.85 ± 0.52; p < 0.05).Conclusions: The quality of implanted stem cells is closely related to treatment efficacy and determines whether the defective self-repair in the necrotic area can be corrected to enhance repair and thus achieve the desired therapeutic outcome.

show abstract

“…Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients [1]. The course of this disease is progressive, and the arthritis severity gradually increases [2] until patients with late-stage ONFH require total hip arthroplasty (THA) [3]. In clinical practice, it is 3 challenging to determine how to prevent the progression of early-stage ONFH or to completely repair the necrotic areas to avoid THA.…”

Section: Introductionmentioning

confidence: 99%

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Wu

¹

,

Sun

²

,

Liu

³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients. Repair of the necrotic area is key to successful treatment. Currently, the combination of stem cell transplantation and decompression is used clinically to promote the repair of necrotic areas based on the characteristics of stem cells. However, a considerable number of patients do not achieve a satisfactory outcome in terms of repair of the femoral head necrotic area, and it is very important to determine the reasons for the poor curative effect. The aim of this study was to investigate the correlation between stem cell viability and the repair efficacy of stem cell therapy combined with core decompression for early-stage ONFH. Methods: A total of 30 patients with idiopathic ONFH underwent core decompression combined with autologous stem cell transplantation. The Harris hip score (HHS) and difference in necrosis area before and after surgery were measured. The mean repair ratio was set as the threshold to divide the patients into group A (ratio above the mean) and group B (ratio below the mean). The ultrastructure, proliferative capacity, and multidirectional differentiation ability were compared between the groups. Results : At 9 months after surgery, the HHS and magnetic resonance imaging (MRI) findings improved by varying degrees. Based on the mean repair ratio of (62.2 ± 27.0)%, the threshold for dividing the patients into groups A and B was set to 62.2%. Better repair (group A) was associated with more rapid proliferation and a healthier ultrastructure. The cells in group A showed stronger specific staining signifying osteogenic and chondrogenic differentiation; alkaline phosphatase (ALP) activity, an indicator of osteogenic differentiation, was higher in group A than in group B (OD, 2.39 ± 0.44 and 1.85 ± 0.52; p < 0.05). Conclusions: The quality of implanted stem cells is closely related to treatment efficacy and determines whether the defective self-repair in the necrotic area can be corrected to enhance repair and thus achieve the desired therapeutic outcome.

show abstract

Osteonecrosis of the femoral head with subchondral collapse

Cited by 13 publications

References 6 publications

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

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