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Core decompression and implantation of bone marrow mononuclear cells with porous hydroxylapatite composite filler for the treatment of osteonecrosis of the femoral head

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Implanted bone marrow mononuclear cells (BMMCs) may promote both osteogenesis and angiogenesis in the femoral head. The aim of this study was to investigate the effectiveness of core decompression and implantation of BMMCs with porous hydroxyapatite bone filler for the treatment of osteonecrosis of the femoral head (ONFH).

Methods

Patients with ONFH underwent core decompression and implantation of nano-hydroxyapatite/polyamide bone filler with or without BMMCs. Primary outcomes were changes in Harris hip and visual analogue scale (VAS) pain scores. Secondary outcomes included radiological and clinical success rates, adverse events, and complications.

Results

Demographic/baseline characteristics were similar between groups (BMMC, n = 17 with 26 ONFH hips; control, n = 17 with 27 ONFH hips). Harris hip scores were significantly increased (P < 0.05) in both groups of patients after surgery (last follow-up). The magnitude of increase was significantly greater in the BMMC as compared with the control group (28.6 ± 0.5 vs. 18.4 ± 1.7 %, P < 0.001). VAS scores were significantly decreased (P < 0.05) in both groups after surgery (last follow-up). The magnitude of decrease was significantly greater in the BMMC as compared with the control group (−66.3 ± 1.4 vs. −51.7 ± 2.9 %, P < 0.001). Radiological and clinical success rates were significantly higher in the BMMC as compared with the control group (82.5 vs. 40.7 % and 75.4 vs. 37.0 %, respectively, P < 0.001). Postoperative collapse of the femoral head was less common in the BMMC as compared with the control group (17.5 vs. 59.3 %, P < 0.01).

Conclusions

Both core decompression with or without implantation of BMMC are effective treatment for ONFH. However, core decompression with implantation of BMMCs and porous hydroxyapatite bone filler may be a more effective treatment for ONFH.

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Acknowledgments

The experiments described in this manuscript comply with the current laws of the People’s Republic of China.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, The PLA 307th Hospital, No.8, Fengtaidongda Road, Beijing, 100071, People’s Republic of China

    Yaosheng Liu, Shubin Liu & Xiuyun Su

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  1. Yaosheng Liu
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  2. Shubin Liu
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  3. Xiuyun Su
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Correspondence to Shubin Liu.

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Liu, Y., Liu, S. & Su, X. Core decompression and implantation of bone marrow mononuclear cells with porous hydroxylapatite composite filler for the treatment of osteonecrosis of the femoral head. Arch Orthop Trauma Surg 133, 125–133 (2013). https://doi.org/10.1007/s00402-012-1623-3

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  • DOI: https://doi.org/10.1007/s00402-012-1623-3

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