gms | German Medical Science

Objectives: In early-stage avascular osteonecrosis of the femoral head, "autologous stem cell therapy" has been suggested to improve the prognosis. BioCue is a new commercially available bone marrow aspirate concentration system for which until now studies are lacking. The aim of aur study is the investigation of the short-term functional outcome and MRI results after transplantation of autologous concentrated bone marrow with the BioCue system in patients with osteonecrosis of the femoral head.

Methods: We prospectively registered all cases of femoral head necrosis treated with BioCue in the period from 01/2015 until 05/2016. The surgical procedure was performed by a lateral subtrocanteric stab incision and controlled by image converter. Bone marrow was extracted from the anterior iliac crest and prepared with the BioCue-System. A histological examination was used for verification of the diagnosis. For follow-up, clinical examination by using the Oxford hip score and MRI examinations were registered every 3 months. We also monitored adverse effects and therapy conversions for hip arthroplasty.

Results and Conclusion: In 26 Patients (5 female, 21 male; age range 27 to 63 years), a total of 43 procedures were performed. Mean age at diagnosis was 31y. Follow-up time was 7-24 months. In 6 patients, a bilateral intervention was done, and in 2 patients, the procedure was repeated. In one patient, conversion to hip arthroplasty was performed. No surgical complications or adverse effects were observed.

In early-stage femoral head necrosis, autologous bone marrow aspirate transplantation with the BioCue system can be considered as a joint-preserving therapy option with very low complication rates. Due to the minimal surgical tissue damage, following surgical therapies are not affected. More patients will be included and all patients followed-up continuously in order to get long-term data on this therapy.