Artikel
Autologous bone marrow mesenchymal stem cells associated with tantalum rod implantation and vascularized iliac grafting for the treatment of end-stage osteonecrosis of the femoral head: 9 years follow-up
Suche in Medline nach
Autoren
Veröffentlicht: | 6. November 2018 |
---|
Gliederung
Text
Objectives: Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH) to avert the need for total hip arthroplasty (THA). However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH.
Methods: This single-center randomized clinical trial was conducted in a university-affiliated hospital in China between October 2007 and October 2008. The objective of this study was to assess the efficacy of a protocol involving BMSCs associated with tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. The pro- tocol of the present study was approved by the Institutional Review Board of Dalian University and the Ethics Committee of the City of Dalian under the authorization of the Ministry of Public Health of China. Written informed consent was obtained from each patient before enrollment.A total of 24 patients (31 hips) with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips.
Results and conclusion: All patients were followed for a mean time of 110.35 ± 12.03 months (range 74-122). Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 85.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22-50) to 77.23 ± 14.75 points (range 33-95). This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.