Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Hernigou, Philippe; Daltro, Gildásio; Hernigou, Jacques

doi:10.1007/s00264-018-4026-4

Cited by 19 publications

(8 citation statements)

References 43 publications

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“…He described a substantial repair and stabilization of necrotic femoral heads with percutaneous injection of autologous BMC, in combination with surgical core decompression. In a later paper, he reviews three decades of BMC therapies in hip osteonecrosis, emphasizing the quality of the BMC and cellular competence and addressing the effects of BM cell concentrates on the microenvironmental changes within osteonecrotic bone [124]. Other groups reported on prospective randomized clinical trials for femoral head osteonecrosis, comparing surgical decompression alone versus decompression augmented by autologous BMC preparations.…”

Section: Osteonecrosismentioning

confidence: 99%

The Rationale of Autologously Prepared Bone Marrow Aspirate Concentrate for use in Regenerative Medicine Applications

Everts¹,

Flanagan²,

Rothenberg³

et al. 2020

Regenerative Medicine

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Autologously prepared bone marrow aspirate concentrates, have the potential to play an adjunctive role in various patient pathologies that have not been able to heal with conventional treatment modalities. The use of bone marrow aspirate (BMA) and concentrates in regenerative medicine treatment plans and clinical applications is based on the fact that bone marrow cells, including progenitor and nucleated cells, platelets, and other cytokines, support in tissue healing and tissue regenerative processes. The use of concentrated BMA cells focuses primarily on mesenchymal stem cells (MSCs), with the ability to self-renew and differentiate into multiple cell types. Concentrated bone marrow cells can be retrieved from harvested BMA and ensuing minimal manipulative cell processing techniques, executed at point of care (POC). The application of bone marrow biological therapies may offer solutions in musculoskeletal pathologies, spinal disorders, chronic wound care, and critical limb ischemia (CLI), to effectively change the local microenvironment to support in tissue healing and facilitate tissue regeneration. This chapter will address the cellular content of bone marrow tissue, harvesting and preparation techniques, and discuss the biological characteristics of individual marrow cells, their inter-connectivity, and deliberate on the effects of BMA concentration.

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Section: Osteonecrosismentioning

confidence: 99%

The Rationale of Autologously Prepared Bone Marrow Aspirate Concentrate for use in Regenerative Medicine Applications

Everts¹,

Flanagan²,

Rothenberg³

et al. 2020

Regenerative Medicine

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show abstract

“…New treatment methods are required, such as biologic regeneration of necrotic bone [ 124 ]. The treatment using stem cells from bone marrow have been recently introduced in the clinical practice [ 125 ]. Moreover, PDLLA and PLGA had been utilized as promising means to deliver bioactive molecules.…”

Section: Clinical Applications In Drug Deliverymentioning

confidence: 99%

Scaffolds as Structural Tools for Bone-Targeted Drug Delivery

et al. 2018

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Although bone has a high potential to regenerate itself after damage and injury, the efficacious repair of large bone defects resulting from resection, trauma or non-union fractures still requires the implantation of bone grafts. Materials science, in conjunction with biotechnology, can satisfy these needs by developing artificial bones, synthetic substitutes and organ implants. In particular, recent advances in materials science have provided several innovations, underlying the increasing importance of biomaterials in this field. To address the increasing need for improved bone substitutes, tissue engineering seeks to create synthetic, three-dimensional scaffolds made from organic or inorganic materials, incorporating drugs and growth factors, to induce new bone tissue formation. This review emphasizes recent progress in materials science that allows reliable scaffolds to be synthesized for targeted drug delivery in bone regeneration, also with respect to past directions no longer considered promising. A general overview concerning modeling approaches suitable for the discussed systems is also provided.

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“…Some of the aetiological factors include trauma, haemoglobinopathies such as sickle cell disease (SCD), steroid use, alcohol abuse, smoking, connective tissue diseases such as systemic lupus erythematosus (SLE), diabetes mellitus, hyperlipidaemia, fat embolus syndrome, coagulopathy, impaired fibrinolysis, gout, vasculitis, HIV infection, Gaucher's disease, pancreatitis, cancer chemotherapy and radiation therapy. [1][2][3][4][5] Nevertheless, many cases of ONFH are idiopathic.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Functions and Radiographic Severity of Osteonecrosis of the Head of Femur in South-west Nigeria

Thanni¹,

Gbadegesin²

2021

Ann Health Res

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Background: Osteonecrosis of the femoral head is likely to be a complex of diseases rather than a single entity. In sub-Saharan Africa, epidemiological studies on the subject are uncommon. Objectives: To determine hip function, radiographic severity and other characteristics of patients with osteonecrosis of the femoral head (ONFH) at presentation in a sub-Saharan Africa population Methods: A combined prospective clinical survey and retrospective chart review of patients was done. Results: Fifty hips in 44 patients were studied (29 retrospectively and 15 prospectively). The prevalence of ONFH was 1.6%. The mean age was 24.8±13.2 years. The lesion was unilateral in 86.4% and bilateral in 13.6% of the hips. Sickle Cell Disease (SCD) occurred in 43.2%, sickle cell trait in 13.6%, and 20.5% of cases were idiopathic. Overall, 12% of affected hips were presented early, and all the hips were painful at presentation. Of the 18 hips studied prospectively, 72.2% had necrosis >30% and >30% subchondral collapse in 61.1%. The mean combined necrotic angle was moderate size, 197o±29.7o and 177.2o±69.4o for the right and left hips, respectively (p = 0.8). The mean WOMAC scores were 37.2 ±17.4 for function, 10.2±4.3 for pain and 4.2±2.7 for stiffness. Conclusion: Patients with osteonecrosis of the femoral head tended to be young adults and those with SCD. The majority present with large-sized osteonecrosis and subchondral collapse but moderate hip pain and stiffness.

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Hip osteonecrosis: stem cells for life or behead and arthroplasty?

Cited by 19 publications

References 43 publications

The Rationale of Autologously Prepared Bone Marrow Aspirate Concentrate for use in Regenerative Medicine Applications

The Rationale of Autologously Prepared Bone Marrow Aspirate Concentrate for use in Regenerative Medicine Applications

Scaffolds as Structural Tools for Bone-Targeted Drug Delivery

Evaluation of the Functions and Radiographic Severity of Osteonecrosis of the Head of Femur in South-west Nigeria

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