Ten-year results of concentrated autologous bone marrow aspirate transplantation for osteonecrosis of the femoral head: a retrospective study

Tomaru, Yohei; Yoshioka, Tomokazu; Sugaya, Hisashi; Kumagai, Hiroshi; Hyodo, Koji; Aoto, Katsuya; Wada, Hiroshi; Akaogi, Hiroshi; Yamazaki, Masashi; Mishima, Hajime

doi:10.1186/s12891-019-2797-4

Cited by 26 publications

(25 citation statements)

References 33 publications

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“…In contrast, in Japan, CD has not been performed at all except for biopsy purposes. Recently, CD‐based cell therapy has become available at just one university hospital in Japan 21 .…”

Section: Discussionmentioning

confidence: 99%

Difference in Therapeutic Strategies for Joint‐Preserving Surgery for Non‐Traumatic Osteonecrosis of the Femoral Head between the United States and Japan: A Review of the Literature

Kuroda

Okuzu

Kawai

et al. 2021

Orthopaedic Surgery

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For patients with non‐traumatic osteonecrosis of the femoral head (ONFH), core decompression (CD) and bone grafts (BG) are mainly performed in the West, while osteotomy is found to be predominant in Japan. It is not well recognized how the surgical procedures for joint preservation in patients with ONFH are completely different between the United States and Japan. This paper identifies the contexts and the differences in treatment strategies for ONFH between the two countries. We compared the surgical trends of the two countries over three periods, 1997–2001, 2002–2006, and 2007–2011 (the US data for the third period was 2007–2008), based on a 2014 US paper and a 2013 national publication in Japan. We compared the details of surgery for non‐traumatic ONFH under the same conditions in the two reports. For the period 1997–2001, the rates of surgeries for ONFH in the US were as follows: total hip arthroplasty (THA), 86%; CD, 10%; and osteotomy, 0.4%. In Japan, THA was 61%, osteotomy 38%, and CD 0%. For the recent period, 2007–2011 (US 2007–2008), the rate of THA was 91%, CD 6%, and osteotomy 0.1%, in the US, compared to a THA rate of 73%, CD 0%, and osteotomy 26% in Japan. The results for the interim period (2002–2006) were between the old and new data. The use of joint‐preserving surgery for ONFH differs greatly between the US and Japan. The first‐line joint‐preserving surgery was CD in the US and osteotomy in Japan. Each procedure was rarely done in the other country. From about 2000 to 2010, the percentage of THA increased in both countries. The proportion of joint‐preserving surgery (CD in the US and osteotomy in Japan) declined. The decrease in joint‐preserving procedures may be largely attributed to improved long‐term outcomes of THA due to technological advances. There is also a reluctance for young ONFH patients to undergo joint‐preserving procedures, such as osteotomy, that require long‐term hospitalization.

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“…In contrast, in Japan, CD has not been performed at all except for biopsy purposes. Recently, CD‐based cell therapy has become available at just one university hospital in Japan 21 .…”

Section: Discussionmentioning

confidence: 99%

Difference in Therapeutic Strategies for Joint‐Preserving Surgery for Non‐Traumatic Osteonecrosis of the Femoral Head between the United States and Japan: A Review of the Literature

Kuroda

Okuzu

Kawai

et al. 2021

Orthopaedic Surgery

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“…Studies have reported low efficacy of cell therapy in advanced ONFH patients (Table 3 ). Tomaru et al [ 23 ] reported a 43.2% (16/37) survival rate at 12 years postoperatively using bone marrow mononuclear cell (BMMNC) transplantation for advanced ONFH [ 23 ]. Wang et al also reported a 66.6% (6/9) survival rate with BMMNC therapy at 2.3 years postoperatively [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous autologous impaction bone graft for advanced femoral head osteonecrosis: a retrospective observational study of unsatisfactory short-term outcomes

et al. 2021

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Background Half of osteonecrosis of the femoral head (ONFH) patients suffer femoral head collapse at initial diagnosis, and more than half are bilaterally affected. This study developed a percutaneous autologous impaction bone graft (IBG) technique as a modification of core decompression (CD). We also summarized the short-term results and treatment efficacy of percutaneous autologous IBG in advanced ONFH. Methods Twenty patients (12 males, 8 females) with nontraumatic, postcollapse ONFH except one case underwent CD (10-mm core diameter) and reverse IBG. Radiological changes of the ONFH stage and type were analyzed. Survival analysis using Kaplan–Meier estimates was performed with conversion to total hip arthroplasty (THA) as the endpoint. In addition, the Harris hip score (HHS) and University of California, Los Angeles (UCLA) activity rating scale were evaluated. Results Percutaneous autologous IBG was performed successfully, with an average operation time of < 1 h and small blood loss, and 7 patients (35%) needed conversion to THA at an average of 17 months postoperatively. We observed radiological progressive change in 60% of the patients during a mean observation period of 3 years. The mean clinical scores, except data recorded, after THA significantly improved (before vs. after 3 years: UCLA activity score, 3.7 vs. 5.2 [P = 0.014]; HHS, 57.6 vs. 76.5 points [P = 0.005]). In addition, 6 patients showed radiological progression but no clinical deterioration. Conclusions Percutaneous autologous IBG was technically simple and minimally invasive, but short-term results were unsatisfactory for advanced ONFH. Indications for this procedure should be carefully examined to improve it in order to enable bone formation.

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“… 13 , 14 The THA conversion rate certainly remains low with AALCO treatment compared to 75% THA conversion rate reported in patients with natural progression to osteoarthritis resulting from osteonecrosis of the femoral head. 15 , 16 A randomized study found autologous osteoblastic cells implantation to be more efficacious than bone marrow implantation as an adjunct to core decompression. The disease progression rate was found to be 20% in patients who had undergone autologous osteoblasts implantation vs 47% in patients in the bone marrow implantation group.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study on Implantation of Autologous-Cultured Osteoblasts for the Treatment of Patients with Avascular Necrosis of the Femoral Head

Palekar¹,

Bhalodiya²,

Archik³

et al. 2021

ORR

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Purpose Osteonecrosis of the femoral head is a progressive and debilitating disease that causes pain, osteoarthritis and hip joint collapse, eventually necessitating hip replacement. This study evaluated the long-term outcomes of autologous adult live-cultured osteoblasts (AALCO) implantation in patients with osteonecrosis of femoral head. Patients and Methods In this retrospective multicenter study, we collated and analyzed data of patients ≥12 years of age who underwent AALCO (OSSGROW ® ) between 2010 and 2015 for the treatment of osteonecrosis of the femoral head. Results Data from 64 patients (101 hip joints) were assessed in this study. The mean ±SD duration of disease since diagnosis of osteonecrosis was 7.4±1.6 years. The mean follow-up duration was 6.3±1.4 years. The mean VAS score (n=98 hips) reduced significantly from 58.8 ± 13.8 to 32.2 ± 32.1 post-operatively (mean difference: −26.5±35.2, p=0.001) and Harris hip score (n=97 hips) also significantly improved from 47.1±12.3 to 63.7±27.7 post-operatively (mean difference:16.7±28.7, p=0.0001). Following the AALCO treatment, 29 hips in 13 patients (28.7%) underwent total hip replacement (THA), indicating that AALCO treatment could delay THA for 71.3% of hips. A total of 39.1% of hips diagnosed in early stage versus 60.8% in the late stage of osteonecrosis required THA. Overall, 60.4% of hips improved, 2% remained stable, and 37.6% progressed following the AALCO implantation. The condition of disease was found to have improved in 71.1% of patients in early stage (Grades I and II) versus 58% in the late stage (Grades III and IV) of osteonecrosis. Conclusion Patients with osteonecrosis who received implantation of autologous-cultured osteoblasts using AALCO showed improvement in joint function and decrease in pain. Treatment with AALCO halted progression of osteonecrosis, preserved the natural hip, and eliminated the need for hip replacement surgeries in 7 out of 10 patients.

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Ten-year results of concentrated autologous bone marrow aspirate transplantation for osteonecrosis of the femoral head: a retrospective study

Cited by 26 publications

References 33 publications

Difference in Therapeutic Strategies for Joint‐Preserving Surgery for Non‐Traumatic Osteonecrosis of the Femoral Head between the United States and Japan: A Review of the Literature

Difference in Therapeutic Strategies for Joint‐Preserving Surgery for Non‐Traumatic Osteonecrosis of the Femoral Head between the United States and Japan: A Review of the Literature

Percutaneous autologous impaction bone graft for advanced femoral head osteonecrosis: a retrospective observational study of unsatisfactory short-term outcomes

Retrospective Study on Implantation of Autologous-Cultured Osteoblasts for the Treatment of Patients with Avascular Necrosis of the Femoral Head

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