Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Wu, Zhan; Sun, Qi; Liu, Ming; Grottkau, Brian E.; He, Zijiang J.; Zou, Qiang; Ye, Chuan

doi:10.1186/s12891-020-3064-4

Cited by 21 publications

(4 citation statements)

References 37 publications

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“…Wu et al . treated 30 patients with CD using a 6.5-mm drill, curettage and BMAC soaked in collagen sponge and showed significant improvement in HHS and VAS score after mean follow-up of 9 months (HHS: 84.66, VAS: 1.91; P < 0.05) [ 35 ]. The necrotic area was evaluated by MRI, and repair ratio was calculated by dividing the difference of this area before and after 9 months of surgery, by the area before surgery and multiplying the value by 100.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of orthobiologic adjuvants to core decompression for hip preservation in avascular necrosis hip

Kumar

Shetty²,

Dhillon

2020

Journal of Hip Preservation Surgery

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Head preserving modalities in avascular necrosis (AVN) hip are variably effective in early stages, and further options that could prevent head distortion and osteoarthritis are needed. Core decompression (CD) is the most commonly used surgery in the early stages of osteonecrosis with variable rates of success. The present review aimed to determine the effectiveness of bone marrow aspirate concentrate (BMAC), platelet-rich plasma (PRP), bone morphogenetic proteins (BMP) or their combination with CD in early stages of AVN hip, prior to collapse of femoral head. Additionally, any newer unexplored modalities were also searched for and ascertained. PubMed and SCOPUS databases were searched for relevant articles in English language describing CD with aforementioned orthobiologics. We analysed a total of 20 studies published between 2011 and 2020. There were 6 retrospective and 14 prospective studies. PRP showed improved survival and functional outcomes; however, with only three studies, there is inconclusive evidence for its routine utilization. BMAC enhances the efficacy of CD which can further be increased by culture and expansion of cells or combining it with PRP to stimulate growth. In conclusion, CD with BMAC works more efficiently than CD alone prior to collapse of femoral head in AVN. However, PRP needs more evidence for extensive application. Addition of PRP to BMAC or culturing the latter could further enhance the potency of CD + BMAC combination. Very limited data is available for the efficacy of BMP-7 and the role of intraosseous bisphosphonates should be evaluated for a cheaper and potential alternative.

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Section: Resultsmentioning

confidence: 99%

Efficacy of orthobiologic adjuvants to core decompression for hip preservation in avascular necrosis hip

Kumar

Shetty²,

Dhillon

2020

Journal of Hip Preservation Surgery

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“…In most studies reported to date, the improvement in clinical symptomatology and functionality of the hip is a constant, although the values are notably higher than those obtained in our clinical trial. Sen et al [ 31 ], for example, found results over 76 points on the HHS at 12 months, and Wu et al [ 32 ] found a mean of 84.66 in the HHS and a VAS of 1.91 after nine months of treatment.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of a Phase I/II Clinical Trial of Autologous Mesenchymal Stem Cell Therapy for Femoral Head Osteonecrosis

Blanco

García‐García

Villarón

et al. 2023

JCM

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(1) Background: Osteonecrosis of the femoral head (ONFH) is characterized by impaired vascularization with ischemia resulting in bone cell death, leading to the deterioration of the hip joint. Mesenchymal stem/stromal cells (MSCs) are an attractive potential therapeutic approach in this setting. The aim of this study is to evaluate the clinical improvement in terms of pain and quality of life, as well as the safety of the procedure during the follow-up of patients. (2) Methods: A Phase I–II Open-Label Non-Randomized Prospective clinical trial was conducted. Eight patients with idiopathic ONFH and stage < IIC in the ARCO classification were included. Four weeks before therapy, 40 mL of autologous bone marrow was obtained, and MSCs were expanded under Good-Manufacturing-Practice (GMP) standards. Study medication consisted of a suspension of autologous BM-derived MSCs (suspended in a solution of 5–10 mL of saline and 5% human albumin) in a single dose of 0.5–1 × 106 cells/kg of the patient, administered intraosseously with a trocar and under radioscopic control. Per-protocol monitoring of patients included a postoperative period of 12 months, with a clinical and radiological assessment that included the visual analog scale (VAS), the Harris scale, the SF-36, and the radiological evolution of both hips. In addition, all patients were further followed up for eight years to assess the need for long-term total hip replacement (THR) surgery. (3) Results: Median age of patients included was 48.38 ± 7.38 years, and all patients were men. Autologous MSCs were expanded in all cases. There were no adverse effects related to cell administration. Regarding efficacy, both VAS and ODI scores improved after surgery. Radiologically, 12.5% of patients improved at the end of follow-up, whereas 50% improved clinically. No adverse effects related to the procedure were recorded, and none of the patients needed THR surgery within the first year after MSC therapy. (4) Conclusions: The use of autologous MSCs for patients with ONFH disease is feasible, safe in the long term, and potentially effective.

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“…Через 9 месяцев после оперативного вмешательства оценка по шкале Harris'а достигла 84,66 баллов, оценка по ВАШ боли снизилась до 1,91 на фоне уменьшения объёма очага некроза. На протяжении периода наблюдения ни одному из 30 пациентов не потребовалось ТЭТС [25]. Вероятно, такие результаты, в первую очередь, можно объяснить малым периодом наблюдения за пациентами.…”

Section: результаты и обсуждениеunclassified

Autological bone marrow concentrate for the treatment of early stages of femoral head avascular necrosis (literature review)

Panin,

Zagorodnii,

Boiko

et al. 2024

vmirvz

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Relevance. In the treatment of the early stages of the femoral head osteonecrosis core decompression is widely used, which reduces intraosseous pressure and increases blood flow to the femoral head. To increase the efficiency of the core decompression the use of various bioadjuvants, including concentrate of autologous bone marrow cells is needed, the appropriateness of which is actively discussed.Purpose of the systematic review: evaluation of the effectiveness of autologous bone marrow cells in core decompression in the treatment of the early stages of the femoral head osteonecrosis according to the literature.Material and methods. Articles with clinical data in full text in English or Russian available in the Internet (PubMed and elibrary databases) were included in the study. Articles containing actual data on the stage of osteonecrosis, the number of femoral heads operated on, the use of autologous bone marrow cells as an adjunct to the core decompression of the femoral head, the number of ineffective surgical interventions after which total hip arthroplasty was required were included.Results. Sixteen original articles (2011–2022) were analyzed, and the results of 1135 femoral heads treatment (892 with autologous bone marrow cells, 243 without autologous bone marrow cells, control group) were evaluated. Patient follow-up periods ranged from 9 to 120 months, averaging 45 months. When using autologous bone marrow cells, the need for total hip arthroplasty was observed in 168 of 892 patients (18.8 %); when core decompression was used without autologous bone marrow cells, the rate of total hip arthroplasty was 27.2 % (p > 0.05). Only 2 articles out of 16 authors did not consider autologous bone marrow cells to be reasonable in the core decompression of femoral head.Conclusion. The use of autologous bone marrow cells concentrate as a bioadjuvant in the core decompression slows the progression of osteonecrosis. According to the overwhelming number of authors, the core decompression using autologous bone marrow cells is highly effective, significantly reducing the intensity of pain syndrome and improving the function of the hip joint. The results will be more encouraging with the further development of regenerative medicine, which will provide new samples of cellular preparations for bone tissue structure restoration.

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Correlation between the efficacy of stem cell therapy for osteonecrosis of the femoral head and cell viability

Cited by 21 publications

References 37 publications

Efficacy of orthobiologic adjuvants to core decompression for hip preservation in avascular necrosis hip

Efficacy of orthobiologic adjuvants to core decompression for hip preservation in avascular necrosis hip

Long-Term Results of a Phase I/II Clinical Trial of Autologous Mesenchymal Stem Cell Therapy for Femoral Head Osteonecrosis

Autological bone marrow concentrate for the treatment of early stages of femoral head avascular necrosis (literature review)

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