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Autologous bone marrow mesenchymal stem cells associated with tantalum rod implantation and vascularized iliac grafting for the treatment of end-stage osteonecrosis of the femoral head.

Zhao D, Liu B, Wang B, Yang L, Xie H, Huang S, Zhang Y, Wei X - Biomed Res Int (2015)

Bottom Line: However, there have been unsatisfactory success rates for end-stage ONFH.The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH.The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Zhongshan Hospital of Dalian University, Jiefang Street No. 6, Dalian, Liaoning 116001, China.

ABSTRACT
Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH) to avert the need for total hip arthroplasty (THA). However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips) with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26-78). Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22-50) to 77.23 ± 14.75 points (range 33-95). This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.

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A 40-year-old male patient with ARCO stage IV ONFH at right received the treatment of BMSCs associating with porous tantalum rod implantation combined with vascularized iliac grafting. Radiographs were taken before operation (a), 18 months after operation (b), and 54 months after operation (c). (c) The femoral head remained circular, but collapse was found again in the femoral head.
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fig6: A 40-year-old male patient with ARCO stage IV ONFH at right received the treatment of BMSCs associating with porous tantalum rod implantation combined with vascularized iliac grafting. Radiographs were taken before operation (a), 18 months after operation (b), and 54 months after operation (c). (c) The femoral head remained circular, but collapse was found again in the femoral head.

Mentions: Radiographic progression was observed in 3 of the 19 stage IIIc osteonecrosis hips. Two of these 3 hips were converted to THA. Sixteen (84.21%) of the 19 stage IIIc hips exhibited stable stage IIIc disease (Figure 5), and 7 hips had no radiographic progression of stage IV osteonecrosis (Figure 6).


Autologous bone marrow mesenchymal stem cells associated with tantalum rod implantation and vascularized iliac grafting for the treatment of end-stage osteonecrosis of the femoral head.

Zhao D, Liu B, Wang B, Yang L, Xie H, Huang S, Zhang Y, Wei X - Biomed Res Int (2015)

A 40-year-old male patient with ARCO stage IV ONFH at right received the treatment of BMSCs associating with porous tantalum rod implantation combined with vascularized iliac grafting. Radiographs were taken before operation (a), 18 months after operation (b), and 54 months after operation (c). (c) The femoral head remained circular, but collapse was found again in the femoral head.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352743&req=5

fig6: A 40-year-old male patient with ARCO stage IV ONFH at right received the treatment of BMSCs associating with porous tantalum rod implantation combined with vascularized iliac grafting. Radiographs were taken before operation (a), 18 months after operation (b), and 54 months after operation (c). (c) The femoral head remained circular, but collapse was found again in the femoral head.
Mentions: Radiographic progression was observed in 3 of the 19 stage IIIc osteonecrosis hips. Two of these 3 hips were converted to THA. Sixteen (84.21%) of the 19 stage IIIc hips exhibited stable stage IIIc disease (Figure 5), and 7 hips had no radiographic progression of stage IV osteonecrosis (Figure 6).

Bottom Line: However, there have been unsatisfactory success rates for end-stage ONFH.The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH.The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Zhongshan Hospital of Dalian University, Jiefang Street No. 6, Dalian, Liaoning 116001, China.

ABSTRACT
Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH) to avert the need for total hip arthroplasty (THA). However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips) with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26-78). Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22-50) to 77.23 ± 14.75 points (range 33-95). This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.

Show MeSH
Related in: MedlinePlus