Core decompression combined with autologous bone marrow stem cells versus core decompression alone for patients with osteonecrosis of the femoral head: A meta-analysis

Objective. This study aims to systematically evaluate the efficacy and safety of core decompression combined transplantation of autologous bone marrow stem cells (CDBMSCs) for treatment of avascular necrosis of the femoral head (ANFH). Methods. Randomized controlled trials (RCTs) regarding effectiveness of core decompression combined transplantation of autologous bone marrow stem cells for treating ANFH were searched in 8 comprehensive databases prior to September 2016. The data analysis was performed by using the RevMan version 5.3. Results. A total of 11 studies with 507 participants were included. Results showed that CDBMSCs group was more effective than CD group in increasing Harris hip score, decreasing necrotic area of femoral head, collapse of femoral head, and conversion to total hip replacement incidence. In the subgroup analysis, the results did not change in different intervention measure substantially. In addition, the safety of CDBMSCs for ANFH is reliable. Conclusion. Based on the systematic review, our findings suggest that core decompression combined transplantation of autologous bone marrow stem cells appeared to be more efficacious in the treatment at early stages of ANFH.

Download Full-text

Combining Concentrated Autologous Bone Marrow Stem Cells Injection With Core Decompression Improves Outcome for Patients with Early-Stage Osteonecrosis of the Femoral Head: A Comparative Study

The Journal of Arthroplasty ◽

10.1016/j.arth.2015.06.022 ◽

2015 ◽

Vol 30 (9) ◽

pp. 11-15 ◽

Cited By ~ 67

Author(s):

Reza Mostafavi Tabatabaee ◽

Sadegh Saberi ◽

Javad Parvizi ◽

Seyed Mohammad Javad Mortazavi ◽

Mahmoud Farzan

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Femoral Head ◽

Comparative Study ◽

Early Stage ◽

Core Decompression ◽

Autologous Bone Marrow ◽

Bone Marrow Stem Cells ◽

Autologous Bone

Download Full-text

Combination use of core decompression for osteonecrosis of the femoral head: A systematic review and meta-analysis using Forest and Funnel Plots

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1284149 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Linghanqing Wang ◽

XuRong Tian ◽

Keda Li ◽

Chunlei Liu

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Femoral Head ◽

Meta Analysis ◽

Core Decompression ◽

Autologous Bone Marrow ◽

Bone Marrow Stem Cell ◽

Femoral Head Necrosis ◽

Autologous Bone ◽

Marrow Stem Cell

Problem statement. Core decompression (CD) is a very significant process of dealing in the treatment of femoral head necrosis. And CD combined with bone marrow mesenchymal stem cell transplantation has been widely used in clinical practice, but its effectiveness is controversial. This study is carried out to observe its efficacy and outcomes. Objective. This study evaluated the efficacy and safety of CD combined with bone marrow stem cells in the treatment of femoral head necrosis by systematic review and meta-analysis. Methodology. PubMed, The Cochrane Library, Embase, CNKI, Google Scholar and MEDLINE, etc. databases were searched for clinical randomized controlled trials (RCTs) comparing core decompression combined with autologous bone marrow mesenchymal stem cells versus core decompression alone in the treatment of femoral head necrosis. The retrieval period is from the establishment of each database to May 20, 2021. After literature was extracted and literature quality was evaluated, meta-analysis was conducted by using RevMan5.3 software. Results. A total of 420 osteonecrosis of the femoral head 452 patients' data were collected from all studies. Compared with the core decompression alone group, the CD combined with bone marrow stem cell showed marked reduction in the Visual analog scale (VAS), enhanced Harris hip score (HHS) at 12 months and 24 months, slowed down the progression of the disease, decreased the number of hips conversed to total hip arthroplasty (THA) in the future. Conclusion. Core decompression therapy is a very effective and safe treatment process used for ONFH. Moreover, CD combined autologous bone marrow stem cell transplantation can improve the survival rate of the necrotic head, reduce hip pain and delay the disease progression, the rate of THA postoperatively.

Download Full-text

Autologous bone marrow stem cells mediate paracrine axis in non-ischemic model of failing heart: A novel key mechanism?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2006-925669 ◽

2006 ◽

Vol 54 (S 1) ◽

Author(s):

J Garbade ◽

A Schubert ◽

C Lipinski ◽

H Aupperle ◽

M Barten ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Autologous Bone Marrow ◽

Bone Marrow Stem Cells ◽

Failing Heart ◽

Autologous Bone

Download Full-text

Recovery of Blood and Bone Marrow Stem Cells Following Intense Chemotherapy and Autologous Bone Marrow Transplantation

Oncology ◽

10.1159/000226381 ◽

1986 ◽

Vol 43 (5) ◽

pp. 273-277 ◽

Cited By ~ 1

Author(s):

M.R. Thomas ◽

W.A. Robinson ◽

T.I. Mughal ◽

N. Morton ◽

L.M. Glode

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Bone Marrow Transplantation ◽

Marrow Transplantation ◽

Autologous Bone Marrow Transplantation ◽

Autologous Bone Marrow ◽

Bone Marrow Stem Cells ◽

Autologous Bone

Download Full-text

Meta-Analysis and Evidence Base for the Efficacy of Autologous Bone Marrow Mesenchymal Stem Cells in Knee Cartilage Repair: Methodological Guidelines and Quality Assessment

Stem Cells International ◽

10.1155/2019/3826054 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 6

Author(s):

Mohamed E. Awad ◽

Khaled A. Hussein ◽

Inas Helwa ◽

Mohamed F. Abdelsamid ◽

Alexandra Aguilar-Perez ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Mesenchymal Stem Cells ◽

Cartilage Repair ◽

Meta Analysis ◽

Autologous Bone Marrow ◽

Knee Cartilage ◽

Marrow Mesenchymal Stem Cells ◽

Autologous Bone ◽

Coleman Methodology Score

The aim of this study is to review all the published clinical trials on autologous bone marrow mesenchymal stem cells (BM-MSCs) in the repair of cartilage lesions of the knee. We performed a comprehensive search in three electronic databases: PubMed, Medline via Ovid, and Web of Science. A systematic review was conducted according to the guidelines of PRISMA protocol and the Cochrane Handbook for Systematic Reviews of Interventions. The modified Coleman methodology score was used to assess the quality of the included studies. Meta-analysis was conducted to estimate the effect size for Pain and function change after receiving BM-MSCs. Thirty-three studies—including 724 patients of mean age 44.2 years—were eligible. 50.7% of the included patients received cultured BM-MSCs for knee cartilage repair. There was improvement in the MINORS quality score over time with a positive correlation with the publication year. Meta-analysis indicated better improvement and statistical significance in the Visual Analog Scale for Pain, IKDC Function, Tegner Activity Scale, and Lysholm Knee Score after administration of noncultured BM-MSCs when compared to evaluation before the treatment. Meanwhile, there was a clear methodological defect in most studies with an average modified Coleman methodology score (MCMS) of 55. BM-MSCs revealed a clinically relevant improvement in pain, function, and histological regeneration.

Download Full-text

The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1359-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 14

Author(s):

Kun-chi Hua ◽

Xiong-gang Yang ◽

Jiang-tao Feng ◽

Feng Wang ◽

Li Yang ◽

...

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Radiographic Progression ◽

Meta Analysis ◽

Core Decompression ◽

Femoral Head Necrosis ◽

Significant Difference ◽

Autologous Bone ◽

Necrosis Of Femoral Head ◽

Rate Of Success

Abstract Background Core decompression (CD) is an important method for the treatment of osteonecrosis of the femoral head (ONFH). Few articles investigate the influence of core decompression on outcomes of ONFH. This study was carried out to observe the safety and effectiveness of core decompression in the treatment of ONFH. Methods A comprehensive literature search of databases including PubMed, Embase, and Cochrane Library was performed to collect the related studies. The medical subject headings used were “femur head necrosis” and “Core decompression.” The relevant words in title or abstract included but not limited to “Osteonecrosis of the Femoral Head,” “femoral head necrosis,” “avascular necrosis of femoral head,” and “ischemic necrosis of femoral head.” The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Results Thirty-two studies included 1865 patients (2441 hips). Twenty-one studies (1301 hips) using Ficat staging standard, 7 studies (338hips) using Association Research Circulation Osseous (ARCO) staging standard, and University of Pennsylvania system for staging avascular necrosis (UPSS) staging criteria for 4 studies (802 hips). All the studies recorded the treatment, 22 studies (1379 hips) were treated with core decompression (CD) alone, and 7 studies (565 hips) were treated with core decompression combined with autologous bone (CD Autologous bone). Nine subjects (497 hips) were treated with core decompression combined with autologous bone marrow (CD Marrow). Twenty-seven studies (2120 hips) documented the number of conversion to total hip replacement (THA), and 26 studies (1752hips) documented the number of radiographic progression (RP). Twenty-one studies recorded the types of complications and the number of cases, a total of 69 cases. The random-effect model was used for meta-analysis, and the results showed that the overall success rate was 65%. The rate of success showed significant difference on the outcomes of different stages. The rate of success, conversion to THA, and radiographic progression showed significant difference on the outcomes of ONFH using different treatments. Conclusions Core decompression is an effective and safe method of treating ONFH. The combined use of autologous bone or bone marrow can increase the success rate. For advanced femoral head necrosis, the use of CD should be cautious. High-quality randomized controlled trials and prospective studies will be necessary to clarify the effects of different etiology factors, treatments, and postoperative rehabilitation. Until then, the surgeon can choose core decompression to treat ONFH depending on the patient’s condition. Level of evidence I Meta-analysis

Download Full-text