Survival Analysis after Core Decompression in Association with Platelet-Rich Plasma, Mesenchymal Stem Cells, and Synthetic Bone Graft in Patients with Osteonecrosis of the Femoral Head

Purpose The aim of this study was to report the rate of survivorship in patients with osteonecrosis of the femoral head treated with core decompression in association with mesenchymal stem cells (MSCs) implantation, platelet-rich plasma (PRP) injection, and synthetic bone graft. Methods We evaluated 24 hips in 16 patients, according to Ficat classification, treated by core decompression, injection of PRP and MSCs, and backfilling of the core tract with synthetic bone graft. Survivorship was estimated using Kaplan–Meier curves. Results The survivorship of core decompression in association with the procedure is 50% at 75 months of follow-up. The survival rate was 80% for patients in early stage and 28.6% for patients in advanced stage at 75 months. When we compared Kaplan–Meier survival curves of patients in stage III + IV and patients in stage I + II, we noticed that the survival functions are statistically different (p < 0.05, log-rank test), particularly in stage I + II where we had a greater surviving core decompression, in comparison to patients in stage III + IV. Conclusion This technique is safe and good preliminary results were obtained in patients with early stages of the disease with no reported complications. Level of Evidence Level IV, therapeutic case series.

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Injectable synthetic bone graft substitute combined with core decompression in the treatment of advanced osteonecrosis of the femoral head: A 5-year follow-up

Biomedical Journal ◽

10.4103/2319-4170.138307 ◽

2015 ◽

Vol 38 (3) ◽

pp. 257 ◽

Cited By ~ 8

Author(s):

MelS Lee ◽

Pei-An Yu ◽

Kuo-Ti Peng ◽

Tsan-Weng Huang ◽

RobertWen-Wei Hsu ◽

...

Keyword(s):

Femoral Head ◽

Bone Graft ◽

Core Decompression ◽

Bone Graft Substitute ◽

Synthetic Bone ◽

Synthetic Bone Graft

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The effect of mesenchymal stem cells, demineralized bone graft and platelet-rich plasma on osteogenesis in rat tibia defects

International Dental Research ◽

10.5577/intdentres.2021.vol11.suppl1.8 ◽

2021 ◽

Vol 11 (Suppl. 1) ◽

pp. 47-55

Author(s):

Zozan Erdoğmuş ◽

Belgin Gülsün

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Bone Graft ◽

Platelet Rich Plasma ◽

Female Rats ◽

Control Group ◽

Osteoblastic Activity ◽

Group I ◽

Rat Tibia ◽

Demineralized Bone

Aim: Deformities of the jaw and face are often caused by infection, inflammation, and cystic and neoplastic pathological conditions. Defects with various aetiologies should be repaired promptly using the most appropriate approach to reconstruct the anatomical form. To treat defects, bone grafts with various combinations have been used. In particular, combinations including cellular products to enhance osteogenic properties have been implemented. In this study, we aimed to investigate the effects of different materials and cells on bone defects by using mesenchymal stem cells (MSCs), which are thought to have a positive effect on healing, demineralized bone graft (DMB) and platelet-rich plasma (PRP). Methodology: We used 55 female rats weighing between 200-250 g, four of which were used to obtain platelet-rich plasma. The remaining animals were divided into five groups. Group I (n = 6) was the operative control group, Group II (n = 24) was given DMB, Group III (n = 24) was given DMB+PRP, Group IV (n = 24) was given MSC+DBG and Group V (n = 24) was given DMB+PRP+MSC applied to rat tibial defects (10 mm x 3 mm x 2 mm). Results: Statistically significant differences were observed in bone osteoblastic activity in tibia defects among the groups (p<0.05). Conclusion: Bone regeneration was significantly improved in groups where MSCs were used in combination with DMB and PRP. How to cite this article: Erdoğmuş Z, Gülsün B. The effect of mesenchymal stem cells, demıneralızed bone graft and platelet-rıch plasma on osteogenesıs ın rat tıbıa defects. Int Dent Res 2021;11(Suppl.1):47-55. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.8 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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The Use of Platelet-Rich Plasma for the Treatment of Osteonecrosis of the Femoral Head: A Systematic Review

BioMed Research International ◽

10.1155/2020/2642439 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Jun Han ◽

Fuqiang Gao ◽

Yajia Li ◽

Jinhui Ma ◽

Wei Sun ◽

...

Keyword(s):

Stem Cells ◽

Femoral Head ◽

Early Stage ◽

Platelet Rich Plasma ◽

Articular Surface ◽

Experimental Studies ◽

Core Decompression ◽

Comprehensive Overview ◽

Autologous Plasma ◽

Operation Modes

Background. As a pathological process, osteonecrosis of the femoral head (ONFH) is characterized by the avascularity of the femoral head, cellular necrosis, microfracture, and the collapse of the articular surface. Currently, critical treatment for early-stage ONFH is limited to core decompression. However, the efficacy of core decompression remains controversial. To improve the core decompression efficacy, regenerative techniques such as the use of platelet-rich plasma (PRP) were proposed for early-stage ONFH. As a type of autologous plasma containing concentrations of platelets greater than the baseline, PRP plays an important role in tissue repair, regeneration, and the differentiation of mesenchymal stem cells (MSCs). In this review, we present a comprehensive overview of the operation modes, mechanism, and efficacy of PRP for early-stage ONFH treatment. Methods. We searched for relevant studies in the PubMed, Web of Science, and Embase databases. By searching these electronic databases, the identification of either clinical or experimental studies evaluating PRP, MSC, core decompression, and ONFH was our goal. Results. Seventeen studies of PRP and avascular necrosis of the femoral head were evaluated in our review. Ten studies related to the possible mechanism of PRP for treating ONFH were reviewed. Seven studies of the operation modes of PRP in treating ONFH were identified. We reviewed the efficacy of PRP in treating ONFH systematically and made an attempt to compare the PRP operation modes in 7 studies and other operation modes in past studies for early-stage ONFH treatment. Conclusion. PRP treats ONFH mainly through three mechanisms: inducing angiogenesis and osteogenesis to accelerate bone healing, inhibiting inflammatory reactions in necrotic lesions, and preventing apoptosis induced by glucocorticoids. In addition, as an adjunctive therapy for core decompression, the use of PRP is recommended to improve the treatment of early-stage ONFH patients, especially when combined with stem cells and bone grafts, by inducing osteogenic activity and stimulating the differentiation of stem cells in necrotic lesions.

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A MODIFIED DECOMPRESSION AND BONE GRAFT TECHNIQUE FOR THE TREATMENT OF AVASCULAR NECROSIS OF THE FEMORAL HEAD

Journal of Musculoskeletal Research ◽

10.1142/s0218957716500056 ◽

2016 ◽

Vol 19 (01) ◽

pp. 1650005

Author(s):

Ahmad M. Shehadeh ◽

Samer Abed El Al ◽

Ahmad Ja’far ◽

Ahmad Salem ◽

Imad Abo Shahin ◽

...

Keyword(s):

Pain Relief ◽

Femoral Head ◽

Bone Graft ◽

Avascular Necrosis ◽

Core Decompression ◽

Stage I ◽

Harris Hip Score ◽

Graft Material ◽

Modified Technique ◽

Average Operative Time

Objectives: Avascular necrosis (AVN) of the femoral head is a pathologic process resulting from interruption of blood supply to bone. The aim of this paper is to describe the technical aspects and outcome of a modified technique of core decompression and bone graft injection for the treatment of AVNFH. Methods: A total of 20 patients (26 femoral head AVN) Ficat stage I to early III were treated using core decompression kit followed by injection with bone graft material. Nine hips were stage III, 16 stage II and 1 stage I. Average operative time was 25[Formula: see text]min. Results: At a median follow-up of 48 months, 20 hips (77%) had almost complete pain relief while pain persisted in 6 hips (23%). All patients who demonstrated clinical response exhibited radiological stabilization of disease. The mean Harris hip score for all patients’ prior and following surgery were 41 and 85, respectively ([Formula: see text]). Conclusions: Femur head decompression using core decompression kit followed by bone substitute injection can result in long-term pain relief and prevent progression of AVN in the majority of patients.

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The use of platelet-rich plasma for the treatment of osteonecrosis of the femoral head: A systematic review

10.21203/rs.2.16398/v2 ◽

2019 ◽

Author(s):

Jun Han ◽

Fuqiang Gao ◽

Wei Sun ◽

Lijun Shi ◽

Xinjie Wu ◽

...

Keyword(s):

Stem Cells ◽

Femoral Head ◽

Early Stage ◽

Platelet Rich Plasma ◽

Articular Surface ◽

Experimental Studies ◽

Core Decompression ◽

Comprehensive Overview ◽

Autologous Plasma ◽

Operation Modes

Abstract Background: As a pathological process, osteonecrosis of the femoral head (ONFH) is characterized by the avascularity of the femoral head, cellular necrosis, microfracture, and the collapse of the articular surface. Currently, critical treatment for early stage ONFH is limited to core decompression. However, the efficacy of core decompression remains controversial. To improve the core decompression efficacy, regenerative techniques such as the use of platelet-rich plasma (PRP) were proposed for early stage ONFH. As a type of autologous plasma containing concentrations of platelets greater than the baseline, PRP plays an important role in tissue repair, regeneration, and the differentiation of mesenchymal stem cells (MSCs). In this review, we present a comprehensive overview of the operation modes, mechanism and efficacy of PRP for early stage ONFH treatment. Methods: We searched for relevant studies in the PubMed, Web of Science, and Embase databases. By searching these electronic databases, the identification of either clinical or experimental studies evaluating PRP, MSC, core decompression and ONFH was our goal. Results: Seventeen studies of PRP and avascular necrosis of the femoral head were evaluated in our review. Ten studies related to the possible mechanism of PRP for treating ONFH were reviewed. Seven studies of the operation modes of PRP in treating ONFH were identified. We reviewed the efficacy of PRP in treating ONFH systematically and made an attempt to compare the PRP operation modes in 7 studies and other operation modes in past studies for early stage ONFH treatment. Conclusion: PRP treats ONFH mainly through three mechanisms: inducing angiogenesis and osteogenesis to accelerate bone healing; inhibiting inflammatory reactions in necrotic lesions; and preventing apoptosis induced by glucocorticoids. In addition, as an adjunctive therapy for core decompression, the use of PRP is recommended to improve the treatment of early stage ONFH patients, especially when combined with stem cells and bone grafts, by inducing osteogenic activity and stimulating the differentiation of stem cells in necrotic lesions.

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Study of functional outcome of core decompression with platelet rich plasma enhanced cancellous bone graft in avascular necrosis of femoral head grade I and II

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2019.v5.i2j.80 ◽

2019 ◽

Vol 5 (2) ◽

pp. 710-713

Author(s):

Dr. Shri Krishan Soni ◽

Dr. Vishnupratap Singh Chouhan ◽

Dr. Vinay Joshi

Keyword(s):

Femoral Head ◽

Bone Graft ◽

Functional Outcome ◽

Avascular Necrosis ◽

Cancellous Bone ◽

Platelet Rich Plasma ◽

Core Decompression ◽

Cancellous Bone Graft ◽

Necrosis Of Femoral Head

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Management of stage I and II A/B avascular necrosis of femoral head with core decompression autologous cancellous bone grafting and platelet rich plasma factors

Medical Journal of Dr D Y Patil University ◽

10.4103/0975-2870.169881 ◽

2015 ◽

Vol 8 (6) ◽

pp. 713

Author(s):

PranavS Patel ◽

Tushar Agarwal ◽

Mithu Sooknundun ◽

AshutoshR Mohapatra ◽

HiteshS Joshi ◽

...

Keyword(s):

Femoral Head ◽

Avascular Necrosis ◽

Cancellous Bone ◽

Bone Grafting ◽

Platelet Rich Plasma ◽

Core Decompression ◽

Stage I ◽

Cancellous Bone Grafting ◽

Necrosis Of Femoral Head ◽

Plasma Factors

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Clinical Effects of Novel Nanoscaled Core Decompression Rods Combined with Umbilical Cord Mesenchymal Stem Cells on the Treatment of Early Osteonecrosis of the Femoral Head

Journal of Nanomaterials ◽

10.1155/2015/902836 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Hongyang Gao ◽

Guoping Zhang ◽

Jian Wang ◽

Feng Zhao ◽

Yuchen Zhang ◽

...

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Femoral Head ◽

Umbilical Cord ◽

Hip Joint ◽

Core Decompression ◽

Clinical Effects ◽

The Novel ◽

Average Grade ◽

Before And After

Osteonecrosis of the femoral head (ONFH) is one of the most common diseases in orthopedics. In this study, we investigated the clinical effects of novel nanoscaled core decompression rods combined with mesenchymal stem cells on the treatment of the ONFH. 12 adult patients with early ONFH (at the stage of Ficat II) received the treatment using the implantation of novel nanoscaled core decompression rods combined with umbilical cord mesenchymal stem cells. The grade of the patients’ hip was scored by Harris marking system before and after the surgery, and then pairedt-test was done. We assessed the curative efficiency based on the change of the patients before and after the surgery. In particular, the survival rate of femoral head was assessed at 12 months after the surgery. The results demonstrated that according to the standard of Harris Scoring, the average grade of hip joint before the surgery was54.16 ± 4.23points while average grade of hip joint at 12 months after the surgery was85.28 ± 3.65points. So, the implantation of the novel nanoscaled core decompression rods combined with mesenchymal stem cells had satisfactory clinical effects, suggesting that this implantation should be effective to treat early ONFH.

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