AimsThis study aimed to analyze the clinical factors related to the failure of bone grafting through a window at the femoral head-neck junction.MethodsIn total, 119 patients (158 hips) underwent bone grafting for treatment of avascular necrosis of the femoral head. The patients were classified by their ARCO staging and CJFH classification. All patients were clinically and radiographically followed up every three months during the first year and every six months in the following year. The clinical follow-up comprised determination of pre- and postoperative Harris hip scores, while serial AP, frog lateral radiographs, and CT scan were used for the radiographic follow-up.ResultsThe clinical failure of bone grafting was observed in 40 patients. The clinical failure rates in patients belonging to ARCO stage II period, IIIa, and III (b + c) were 25.9%, 16.2%, and 61.5%, respectively, while those in patients belonging to (C + M + L1) type and L2, L3 type disease groups were 1.7%, 38.9%, and 39%, respectively. The clinical failure rates in patients aged below 40 and those aged 40 and over were 20.5% and 39.0%, respectively (all P < 0.05).ConclusionDisease type, disease stage, and patient age are risk factors for failure of bone graft surgery. Patients belonging to ARCO stage II and IIIa showed a good overall response rate, while patients belonging to ARCO stage IIIb and IIIc and those with necrotic lesions involving the lateral pillar (L2 and L3 type) showed high surgical failure rates.

Our results may provide more deep insight into the mechanism and a promising therapeutic target. The next step is to put our emphasis on an experiment level and to verify the novel genes from 13 hub genes.

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Purpose It is an open question whether cell transplantation can provide safety and effective outcome to spinal cord injury (SCI) patient which has remained controversial for almost 40 years. This study aimed to evaluate the safety and efficacy of cell transplantation in SCI patients. Method Studies of the cell transplantation for SCI were retrieved from PubMed, Embase, Medline, Cochrane Library and analyzed quantitative data by Review Manager 5.3.Results Twenty-one clinical controlled studies with 973 patients were included. The pooled results suggested that cell transplantation significantly improved ASIA score, ASIA motor score, ASIA sensory score, Barthel Index score, residual urine volume, rehabilitative time of automatic micturition. Furthermore, subgroup analysis indicated that the stem cells exhibited more potent than the non-stem cells in spinal cord repair. Cell transplantation at more than 14 days after injury showed more significant improvements than that within 14 days from injury. The dosage of cell transplantation between 1-5 × 10 7 and 10-20 × 10 7 was the potent quantity for the patient with SCI. Intrathecal injection and intravenous + intrathecal injection showed more superior to the other method. The top 5 adverse events were febrile reaction (11.5%), neurologic pain (11.3%), headache (2.6%), neurologic deterioration (2.4%), and rigidity or spasticity (1.6%). Conclusion Cell transplantation appears to be a safe therapeutic strategy possessing substantial beneficial effects in the patients with SCI in clinic. Moreover, treating SCI with stem cell, the dosage of cells between 1-5 × 10 7 and 10-20 × 10 7 , in intermediate or chronic phase, minimally invasive techniques, may bring more advantage to SCI patient.