Cell therapy versus simultaneous contralateral decompression in symptomatic corticosteroid osteonecrosis: a thirty year follow-up prospective randomized study of one hundred and twenty five adult patients
| Autor: | Yasuhiro Homma, Philippe Hernigou, Hélène Rouard, Charles Henri Flouzat Lachaniette, Arnaud Dubory, Isaac Guissou, Nathalie Chevallier |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation musculoskeletal diseases medicine.medical_specialty Percutaneous Adolescent medicine.drug_class Decompression Arthroplasty Replacement Hip Mesenchymal Stem Cell Transplantation Transplantation Autologous Young Adult 03 medical and health sciences Femoral head 0302 clinical medicine Femur Head Necrosis medicine Humans Orthopedics and Sports Medicine Prospective Studies 030212 general & internal medicine Stage (cooking) Glucocorticoids 030222 orthopedics business.industry Odds ratio Middle Aged Decompression Surgical Combined Modality Therapy Magnetic Resonance Imaging Surgery Treatment Outcome medicine.anatomical_structure Orthopedic surgery Corticosteroid Female Hip Joint Bone marrow business Follow-Up Studies |
| Zdroj: | International Orthopaedics. 42:1639-1649 |
| ISSN: | 1432-5195 0341-2695 |
| Popis: | Symptomatic osteonecrosis related to corticosteroids has a high risk of progression to collapse in absence of treatment. The purposes of this study were to evaluate the results of autologous bone marrow grafting of the symptomatic hip in adult patients with osteonecrosis and to compare the results with core decompression alone in the contralateral symptomatic hip. A total of 125 consecutive patients (78 males and 47 females) with bilateral osteonecrosis (ON) and who had both hips symptomatic and at the same stage on each side (stage I or II) were included in this study from 1988 to 1998. The volume of osteonecrosis was measured with MRI in both hips; the smaller size ON was treated with core decompression, and the contralateral hip with the larger ON was treated with percutaneous mesenchymal cell (MSC) injection obtained from bone marrow concentration. The average total number of MSCs (counted as number of colony forming units-fibroblast) injected in each hip was 90,000 ± 25,000 cells (range 45,000 to 180,000 cells). At the most recent FU (average 25 years after the first surgery, range 20 to 30 years), among the 250 hips included in the study, 35 hips (28%) had collapsed at the most recent follow-up after bone marrow grafting, and 90 (72%) after core decompression (CD). Ninety-five hips (76%) in the CD group underwent total hip replacement and 30 hips (24%) in the bone marrow graft group (p |
| Databáze: | OpenAIRE |
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