Stem cell therapy in bilateral osteonecrosis: computer-assisted surgery versus conventional fluoroscopic technique on the contralateral side

Hernigou, Philippe; Thiebaut, Benjamin; Housset, Victor; Bastard, Claire; Homma, Yasuhiro; Younes, Chaib; Flouzat-Lachaniette, Charles-Henri

doi:10.1007/s00264-018-3953-4

Cited by 10 publications

(3 citation statements)

References 28 publications

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“…Several previous studies [12,13,21,35] focused on cell therapies have found that there was a clinical improvement of symptoms on patients with ONFH including pain and function scores. However, the efficacy of stem cells in the long term is not clear and remains controversial especially on the progression events [9,11,12,36,37].…”

Section: Discussionmentioning

confidence: 98%

Efficacy and safety of stem cell therapy for the early-stage osteonecrosis of femoral head: a systematic review and meta-analysis of randomized controlled trials

et al. 2020

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Background Osteonecrosis of femoral head (ONFH) is a seriously degenerative disease with no effective therapies to slow its progression. Several studies have reported short-term efficacy of stem cells on early-stage ONFH. However, its long-term effect was still unclear especially on progression events. This study was performed to evaluate the long-term efficacy and safety of stem cells and analyze its optimal age group and cell number. Methods Our review was registered on PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number CRD42020136094. Following PRISMA guideline, we searched 8 electronic databases on January 5, 2020, and rigorous random controlled trials (RCTs) utilizing stem cell therapy on early-stage ONFH were included. Quality and bias were analyzed. Pooled analysis was performed to assess difference between various outcomes. Results A total of 13 RCTs (619 patients with 855 hips) were included. The application of stem cells significantly delayed collapse of femoral head(I2, 70%; RR, 0.54; 95% CI, 0.33 to 0.89; P < .00001) and total hip replacement (THR) (I2, 68%; RR, 0.55; 95% CI, 0.34 to 0.90; P = .02) in the long term. It effectively decreased the events of collapse of femoral head (≥ 60 months) (I2, 0%; RR, 0.37; 95% CI, 0.28 to 0.49; P < .00001) and THR (> 36 months) (I2, 0%; RR, 0.32; 95% CI, 0.23 to 0.44; P < .00001). There existed a beneficial effect for patients under 40 (Collapse of femoral head: I2, 56%; RR, 0.41; 95% CI, 0.23 to 0.76; P = .004) (THR: I2, 0%; RR, 0.31; 95% CI, 0.23 to 0.42; P < .00001). In addition, quantity of stem cells at 108 magnitude had better effects on disease progression events (I2, 0%; RR, 0.34; 95%CI, 0.16 to 0.74; P = .007). Besides, there were no significant differences on adverse events between the stem cell group and control group (I2, 0%; RR, 0.82; 95% CI, 0.39 to 1.73; P = .60). Conclusion Our findings build solid evidence that stem cell therapy could be expected to have a long-term effect on preventing early-stage ONFH patients from progression events, such as collapse of femoral head and total hip replacement. Furthermore, patients under 40 may be an ideal age group and the optimal cell number could be at 108 magnitude for this therapy. Further studies including strict RCTs are required to evaluate a clear effect of stem cells on ideal patient profile and the procedures of implantation.

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Section: Discussionmentioning

confidence: 98%

Efficacy and safety of stem cell therapy for the early-stage osteonecrosis of femoral head: a systematic review and meta-analysis of randomized controlled trials

et al. 2020

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“…The authors [37,[40][41][42][43][44] of this issue critically address specific problems-namely cell quality and competence, and microenvironmental changes occurring at the bone osteonecrosis level. BMSC-which are supposed to be Bfunctionally competent^-are often being collected from the BM of patients with bone disease and concomitant risk factors for bone marrow disease (corticosteroids, alcohol abuse…).…”

Section: Cell Therapy and Osteonecrosismentioning

confidence: 99%

Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Hernigou¹,

Daltro

Hernigou

2018

International Orthopaedics (SICOT)

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“… 9 , 11 Previous studies have demonstrated the accuracy of cup placement in DDH patients with CT. 12 , 13 Moreover, a navigation system has been used not only for THA but also for hip resurfacing arthroplasty, periacetabular osteotomy, and stem cell therapy in osteonecrosis of the hip. 14 - 17 …”

Section: Introductionmentioning

confidence: 99%

Robotic-arm assisted THA can achieve precise cup positioning in developmental dysplasia of the hip

Hayashi

Hashimoto

Kuroda

et al. 2021

Bone & Joint Research

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Aims This study aimed to evaluate the accuracy of implant placement with robotic-arm assisted total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Methods The study analyzed a consecutive series of 69 patients who underwent robotic-arm assisted THA between September 2018 and December 2019. Of these, 30 patients had DDH and were classified according to the Crowe type. Acetabular component alignment and 3D positions were measured using pre- and postoperative CT data. The absolute differences of cup alignment and 3D position were compared between DDH and non-DDH patients. Moreover, these differences were analyzed in relation to the severity of DDH. The discrepancy of leg length and combined offset compared with contralateral hip were measured. Results The mean values of absolute differences (postoperative CT-preoperative plan) were 1.7° (standard deviation (SD) 2.0) (inclination) and 2.5° (SD 2.1°) (anteversion) in DDH patients, and no significant differences were found between non-DDH and DDH patients. The mean absolute differences for 3D cup position were 1.1 mm (SD 1.0) (coronal plane) and 1.2 mm (SD 2.1) (axial plane) in DDH patients, and no significant differences were found between two groups. No significant difference was found either in cup alignment between postoperative CT and navigation record after cup screws or in the severity of DDH. Excellent restoration of leg length and combined offset were achieved in both groups. Conclusion We demonstrated that robotic-assisted THA may achieve precise cup positioning in DDH patients, and may be useful in those with severe DDH. Cite this article: Bone Joint Res 2021;10(10):629–638.

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Stem cell therapy in bilateral osteonecrosis: computer-assisted surgery versus conventional fluoroscopic technique on the contralateral side

Abstract: The findings of this study suggest that computer navigation may be safely used in a basic procedure for injection of stem cells.

Cited by 10 publications

References 28 publications

Efficacy and safety of stem cell therapy for the early-stage osteonecrosis of femoral head: a systematic review and meta-analysis of randomized controlled trials

Efficacy and safety of stem cell therapy for the early-stage osteonecrosis of femoral head: a systematic review and meta-analysis of randomized controlled trials

Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Robotic-arm assisted THA can achieve precise cup positioning in developmental dysplasia of the hip

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