2015, Number 1
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Revista Cubana de Ortopedia y Traumatología 2015; 29 (1)
Implant of Mononuclear Cells in Femoral Head Osteonecrosis
Pérez CD, Echemendía RAL, Cruz SPM, Piloto TKM
Language: Spanish
References: 18
Page: 62-66
PDF size: 118.91 Kb.
ABSTRACT
Aseptic necrosis of the femoral head (AVN-FH) is the death of bone tissue in the
femoral head because of inadequate blood supply; it has been associated with various causes. The degree of destruction of bone architecture and the blood supply network
to the femoral head is extremely affected. In many cases, surgery is necessary as
valgus osteotomies, varus, Sugioka and others. Core decompression associated with
cell therapy was used in this study. A male patient aged 46 is presented here.
this patient has history of Diabetes Mellitus, regular alcohol consumption, he was
diagnosed with aseptic necrosis of the femoral head left hip with CT scan, and he
subsequently underwent surgery by perforated lateral approach trochanteric
(Central Decompression) and administration of autologous mononuclear cells.
The patient was discharged 48 hours after surgery, with limited support during the
first
10 days, and then assisted ambulation. Radiographs were performed at 6 months
after implantation. After a year of surgery the patient is discharged and he is
instructed to return to his usual social activities, noting no progression of
osteonecrosis, thus, non-assisted ambulation is achieved.
REFERENCES
Kim Y, Oh H. The pattern of bone marrow oedema on or MRI in osteonecrosis of the femoral head. J Bone Joint Surg. 2000;82B(6):837-841.
Aigner N, Schneider W. Core decompression in early stages of femoral head osteonecrosis, an MRI controlled study. Int. Orthop. (SICOT)2002;26:31-5.
Hofstaetter JG, Roschger P, Klaushofer K, Kim HK. Increased matrix nineralization in the immature femoral head following ischemic osteonecrosis. Bone. 2010;46:379-85.
Kim H, Bian H, Aya-ay J, Garces A, Morgan EF, Gilbert SR. Hipoxia and HIF-1 expression in the epiphyseal cartilage following ischemic injury to the immature femoral head. Bone. 2009;45:280-88.
Inove S, Horimi M, Asaro T, Fujwka M, Ogura T. Risk factors for nontraumatic osteonecrosis of the femoral head after renal transplantation. J Orthop Sci. 2003;8(6):751-6.
Hernigou P, Bachir D, Galactenos F. The natural history of symptomatic osteonecrosis in adults with sickle cell disease. J Bone Join Surg Am. 2003;85(3):500-4.
Kothapallli R, Aya-ay JP, Blan H, Garces A, Kim HK. Ischaemic injury to femoral head induces apoptotic and oncotic cell death. Pathology.2007; 39:241-46.
Paul CM, Adriana GV, Salvador MH, Carlos PV. Plasma rico en plaquetas. Herramienta versátil de la medicina regenerativa. Cir Cir.2013;81:74-82.
Shapiro F. Femoral head deformation and repair following induction of ischemic necrosis. An histologic and magnetic resonance imaging study in the piglet. J Bone Joint Surg (Am). 2009;91-A:2903-14.
Matsuno HI, Omizu N, Aori M, Minami A. Mild term prognosis of non-traumatic osteonecrosis of the femoral head. J Bone Joint Surg Br. 2003;85(3):796-801.
Muller I, Vaegler M, Holzwarth C, Tzaribatchev N, Pfister SM, Schutt V, et al. Secretion of angiogenic proteins by human multipotentmesenchymal stromal cells and their clinical potential in the treatment of avascular necrosis. Leukemia. 2008;22:2054-61.
Wang Y, Wan C, Deng L, Liu X, Cao X, Gilbert SR, et al. The hypoxia-inducible factor alpha pathway couples angiogenesis to osteogenesis during skeletal development. J Clin Invest. 2007;117:1616-26.
Inove S, Horimi H, Asaro T, Fujwkam M, Ogura T. Risk factors for nontraumatic osteonecrosis of the femoral head after renal transplantation. J Orthop Sci. 2003;8(3):751-6.
Hernigou P, Bachir D, Galactereos F. The natural history of symptomatic osteonecrosis in adults with sickle cell disease. J Bone Joint Surg Am. 2003;85(3):500-4.
Matta J, Ferguson T. Total hip replacement after acetabular fracture. Orthopaedics. 2005;28:959-62.
Haidukewych GJ, Rothwell WS, Jacofsky DJ, Torchia ME, Berry DJ. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am. 2004;86:1711-6.
Raaymakers Ernst LFB, Marti R. Pseudoartrosis del cuello femoral: posibilidades y limitaciones de las diversas modalidades de tratamiento. Indian J Ortopedia. 2008;42:13-21.
Magu NK, Mittal R, Garg R. Osteotomía intertrocantérea en valgo en el cuello fractura intracapsular del fémur. Indian J Ortopedia. 2003;37:6.