Arthroscopic management of a femoral head osteochondral defect using autologous osteochondral transfer, platelet-rich plasma and microfracture

2012 ◽  
Vol 23 (6) ◽  
pp. 629-633 ◽  
Author(s):  
Marc J. Philippon ◽  
Hannah Claire Jarvis
Keyword(s):  
Femoral Head ◽  
Osteochondral Defect ◽  
Platelet Rich Plasma ◽  
Arthroscopic Management

scholarly journals Effect of Oral Losartan on Orthobiologics: Implications for Platelet-Rich Plasma and Bone Marrow Concentrate—A Rabbit Study

2020 ◽  
Vol 21 (19) ◽  
pp. 7374
Author(s):  
Gilberto Y. Nakama ◽  
Sabrina Gonzalez ◽  
Polina Matre ◽  
Xiaodong Mu ◽  
Kaitlyn E. Whitney ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Osteochondral Defect ◽  
Platelet Rich Plasma ◽  
Control Group ◽  
Bone Marrow Concentrate ◽  
Significant Difference ◽  
Losartan Group ◽  
Group 2 ◽  
And Control ◽  
Tgf Β1

Recent efforts have focused on customizing orthobiologics, such as platelet-rich plasma (PRP) and bone marrow concentrate (BMC), to improve tissue repair. We hypothesized that oral losartan (a TGF-β1 blocker with anti-fibrotic properties) could decrease TGF-β1 levels in leukocyte-poor PRP (LP-PRP) and fibrocytes in BMC. Ten rabbits were randomized into two groups (N = 5/group): osteochondral defect + microfracture (control, group 1) and osteochondral defect + microfracture + losartan (losartan, group 2). For group 2, a dose of 10mg/kg/day of losartan was administrated orally for 12 weeks post-operatively. After 12 weeks, whole blood (WB) and bone marrow aspirate (BMA) samples were collected to process LP-PRP and BMC. TGF-β1 concentrations were measured in WB and LP-PRP with multiplex immunoassay. BMC cell populations were analyzed by flow cytometry with CD31, CD44, CD45, CD34, CD146 and CD90 antibodies. There was no significant difference in TGF-β1 levels between the losartan and control group in WB or LP-PRP. In BMC, the percentage of CD31+ cells (endothelial cells) in the losartan group was significantly higher than the control group (p = 0.008), while the percentage of CD45+ cells (hematopoietic cells-fibrocytes) in the losartan group was significantly lower than the control group (p = 0.03).

scholarly journals Peri-implant cartilage and bone histological changes following treatment of focal osteochondral defects in the femoral head with polyether ether ketone implants versus cobalt chromium molybdenum alloy implants: assessment in a goat model

2020 ◽  
Author(s):  
Zhiguo Yuan ◽  
Wei Zhang ◽  
Xiangchao Meng ◽  
Jue Zhang ◽  
Teng TengLong ◽  
...  
Keyword(s):  
Femoral Head ◽  
Osteochondral Defect ◽  
Osteochondral Defects ◽  
Cobalt Chromium ◽  
Cocrmo Alloy ◽  
Polyether Ether Ketone ◽  
Histological Score ◽  
Ether Ketone ◽  
Cobalt Chromium Molybdenum

Abstract Objective: This study aimed to quantitatively investigate the peri-implant histology of applying defect-size polyether ether ketone (PEEK) implant for the treatment of localized osteochondral defects in the femoral head and compared it with cobalt chromium molybdenum (CoCrMo) alloy implant.Methods: A femoral head osteochondral defect model was created in the left hips of goats (n=12). Defects were randomly treated by immediate placement of a PEEK (n=6) or CoCrMo implant (n=6). The un-operated right hip joints served as a control. Goats were sacrificed at 12 weeks. Periprosthetic cartilage quality was semi-quantitatively analyzed macroscopically and microscopically. Implant osseointegration was measured by micro-CT and histomorphometry.Results: The modified macroscopic articular evaluation score in the PEEK group was lower than that in the CoCrMo group (p<0.05), and the histological score of the periprosthetic and acetabular cartilage in the PEEK group was lower than that in the CoCrMo group (P<0.05). The mean bone-implant contact for PEEK implants was comparable with that for CoCrMo alloy implants at 12 weeks.Conclusions: A PEEK implant for the treatment of local osteochondral defect in the femoral head demonstrated effective fixation and superior in vivo cartilage protection compared with an identical CoCrMo alloy implant.

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

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
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.

New Advances in Stem Cell Therapy for Osteonecrosis of the Femoral Head

2019 ◽  
Vol 14 (3) ◽  
pp. 226-229 ◽  
Author(s):  
Wei Zhou ◽  
Ming Qu ◽  
Yajie Lv ◽  
Jinyu Zhu
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Femoral Head ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Hip Replacement ◽  
Early Stage ◽  
Platelet Rich Plasma ◽  
Young Patients ◽  
Plasma Therapy

Osteonecrosis of the femoral head (ONFH) is a common refractory orthopedic disease with multiple etiologies that more frequently occurs in middle-aged and young people. ONFH is the main cause of hip replacement in young patients. Since Professor Hernigou first reported the use of stem cells in the treatment of early stage ONFH, a large number of studies have demonstrated the potential of stem cells in the treatment of adult patients with ONFH. With the rise of interdisciplinary stem cell therapy combined with platelet-rich plasma therapy, gene therapy or other methods have gradually attracted the attention of researchers. This article summarizes the current advances in stem cell therapy for ONFH, as well as the problems and challenges, which may provide reference for further research.

scholarly journals 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

Joints ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 016-022 ◽  
Author(s):  
Riccardo D'Ambrosi ◽  
Elena Biancardi ◽  
Giulia Massari ◽  
Vincenza Ragone ◽  
Renato Facchini
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Femoral Head ◽  
Bone Graft ◽  
Platelet Rich Plasma ◽  
Core Decompression ◽  
Stage I ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Kaplan Meier

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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