Efficacy of autologous stem cell therapy in femoral head avascular necrosis: a comparative study

Abstract

Objective Avascular necrosis of the femoral head is a disease usually seen in middle-aged individuals. Although many aetiological factors have been blamed, there are still aetiological factors that have not been fully elucidated. Although treatment options show a wide range, early and appropriate treatment is of great importance to preserve the hip joint. In our study, we compared the results of core decompression and core decompression combined with bone marrow mesenchymal stem cell implantation in patients with avascular necrosis of the femoral head. Material method In this retrospective study, Steinberg stage 1–2 patients operated on for avascular necrosis of the femoral head between 2018 and 2023 were analysed. Separate groups were formed from patients who underwent isolated core decompression and core decompression + bone marrow mesenchymal stem cell implantation. Age, gender, Steinberg staging, aetiology of the disease, follow-up period, progression to hip arthroplasty, Vas scores, Harris hip scores (HHS), and complications were evaluated. Harris hip scores at preoperative and 2-year follow-up periods; VAS scores at preoperative, 3-month, 6-month, 1-year, and 2-year follow-up periods were analysed. Results In the study, 44 patients were analysed. While 25 patients underwent core decompression only (group 1), 19 patients underwent core decompression and bone marrow mesenchymal stem cell implantation (group 2). The mean age of the patients in group 1 was 39.3 ± 6.5 years, and the mean age of the patients in group 2 was 38.4 ± 6.7 years. The mean follow-up was 31.85 ± 4.4 months in group 1 and 32.2 ± 4.1 months in group 2. Total hip arthroplasty was performed in 2 of the patients in group 1 (one of the patients underwent total hip arthroplasty at month 28 and the other at month 33). Conclusion The treatment of avascular necrosis of the femoral head varies according to various staging methods. Early diagnosis of the disease and correct treatment are very important for the patient's quality of life in the future. In our research, we found that patients who received both core decompression and stem cell implantation for early-stage avascular necrosis of the femoral head exhibited decreased pain at the 6-month, 1-year, and 2-year follow-up examinations. Additionally, their hip function improved at the 24-month mark according to the HHS evaluation.

Long stem revision versus short stem revision with plate osteosynthesis for Vancouver type B2 periprosthetic femoral fracture: a comparative study of eighty five cases

“…VAS scores were assessed to measure pain levels on a scale from 0 to 10. HHSs were used with scores ranging from 0 to 100, where higher scores indicate better functional outcomes and lower scores indicate poorer functional outcomes [ 31 ].…”

Long-Term Outcomes of Cementless Bipolar Hemiarthroplasty in Young Patients With Osteonecrosis of the Femoral Head: The Impact of Implant Improvements and Preoperative Stage

“…Osteonecrosis of the femoral head (ONFH) is a pathological condition that affects from young to older ages, resulting from compromised blood supply to the femoral head due to various etiological factors such as steroid use, alcoholism, and trauma [1]. In young patients, joint-preserving procedures such as core decompression, cell therapy, and femoral osteotomy may be considered [1][2][3]. However, in cases of extensive ONFH or femoral head collapse, arthroplasty is performed due to the ineffectiveness of other treatments [4].…”

Proteomic profiling of extracellular vesicles derived from human serum for the discovery of biomarkers in Avascular necrosis

“…Understanding non-traumatic AVN is challenging for orthopedic surgeons and it is important to elucidate its genetic causes and pathogenic mechanisms [ 12 ]. Surgical or nonsurgical treatment can be selected depending on etiological cause, AVN stage, duration of symptoms, pain, age, systemic condition, and whether the disease is unilateral or bilateral [ 13 ]. Core decompression (CD) is currently the most common treatment for early stage AVN.…”