Core Decompression with Local Administration of Zoledronate and Enriched Bone Marrow Mononuclear Cells for Treatment of Non‐Traumatic Osteonecrosis of Femoral Head

The review of the literature data and our results of surgical treatment of femoral head osteonecrosis in adult patients with the minimally invasive technologies are presented in this article. Using clinical scales, X-rays, MRI, the hip joint condition of 46 patients who underwent “core” decompression in combination with bone plastic (group A, 31 patients) and bone marrow mononuclear cells (group B, 15 patients) were evaluated. The percentage of osteonecrosis progression during the observation period up to 3 years in group A was higher than in group B, where the bone marrow concentrate was used (38.7 and 26.7 %, respectively). The methods of treatment used for femoral head osteonecrosis are not traumatic, have no complications and allow delaying hip replacement. The use of autologous bone marrow cells, in addition to decompression of the necrosis focus, creates the prerequisites for a better outcome of bone regeneration of the necrotic area.

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Treatment of Monolateral Legg-Calvé-Perthes Disease with Autologous Bone Marrow Mononuclear Cells in 32 Dogs

VCOT Open ◽

10.1055/s-0040-1701470 ◽

2020 ◽

Vol 03 (01) ◽

pp. e1-e10 ◽

Cited By ~ 1

Author(s):

Alberto Maria Crovace ◽

Luca Lacitignola ◽

Francesco Staffieri ◽

Edda Francioso ◽

Giacomo Rossi ◽

...

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Minimally Invasive ◽

Head And Neck ◽

Mononuclear Cells ◽

Autologous Bone Marrow ◽

Bone Marrow Mononuclear Cells ◽

Invasive Treatment ◽

The Mean ◽

Autologous Bone

Abstract Objective In the present study, we report our results of the use of autologous bone marrow mononuclear cells (BMMCs) as a minimally invasive treatment for Legg-Calvé-Perthes in dogs. Study Design In accordance with Ljunggren's scale, inclusion criteria were determined by clinical condition and radiographic features of the disease, resulting in 32 dogs enrolled in this retrospective study from 2007 to 2019. Bone marrow was collected from each dog from the iliac crest and the mononuclear fraction was separated with density gradient centrifugation. The mean number of BMMCs was 104.7 ± 46.5 × 106 cells. The mean BMMC colony-forming units were 71.6 ± 51.9 × 102/mL.Cells were suspended in fibrin glue before BMMC administration and implanted via transcutaneous injection under computed tomography or radiographic guidance, using a Jamshidi needle inserted through the femoral head and neck. Results A progressive reduction of pain within 3 weeks after BMMC administration was observed in 28 patients, with gradually increased weight bearing on the affected limb. In four dogs, however, pain and lameness persisted and at 3 months post-BMMC injection, femoral head and neck resection was performed. Histological and immunohistochemical studies were done on samples from those four dogs, which showed evidence of formation of new cartilage and subchondral bone in the area where cells were implanted. Clinical Significance Based on these results, BMMC therapy may be considered as effective and minimally invasive treatment option for LCPD in dogs.

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