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Zellbasierte Therapie der Femurkopfnekrose

Cell based therapy for the treatment of femoral head necrosis

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Zusammenfassung

Das Ziel bei der Therapie der Femurkopfnekrose des Erwachsenen ist es, den Hüftkopf zu erhalten und einen künstlichen Gelenkersatz zu vermeiden. Die Core-Dekompression bietet neben der intraossären Druckentlastung zusätzlich die Möglichkeit, bioaktive Materialien, Substanzen und Zellen in den Bohrkanal einzubringen. Hierzu zählen vaskularisierte und nichtvaskularisierte Knochentransplantate, allogene und synthetische Knochenersatzmaterialien, osteogen und angiogen wirkende Wachstumsfaktoren sowie unterschiedliche Vorläuferzellen. Insbesondere der Einsatz neuer zellbasierter Verfahren hat ein großes therapeutisches Potenzial und könnte zukünftig einen entscheidenden Fortschritt bei der Behandlung der Femurkopfnekrose bedeuten. In diesem Beitrag werden die bisherigen klinischen Erfahrungen der zellbasierten Strategien zur Therapie der Femurkopfnekrose des Erwachsenen zusammenfasst und ein eigener neu entwickelter Therapieansatz unter der Verwendung von Knochenmarkstammzellen (TRCs: „tissue repair cells“) in Kombination mit einer β-TCP-Matrix vorgestellt.

Abstract

The goal of the therapy for necrosis of the femoral head in adults is the preservation of the femoral head and, therefore, avoidance of total joint replacement. Core decompression is known to reduce the intraosseous pressure and additionally provides the opportunity to introduce bioactive materials, substances and cells into the core tract. These include vascularized and non-vascularized bone grafts, allogenic and synthetic bone substitutes, osteogenic and angiogenic growth factors, as well as different progenitor cells. In particular, the use of cell-based strategies has great therapeutic potential and could play an important role in the treatment of femoral head necrosis in adults in the future. In this article, we summarize the existing clinical experience of current cell-based strategies for the treatment of femoral head necrosis in adults, and present a therapeutic approach using bone marrow stem cells (TRCs: tissue repair cells). in combination with a β-TCP matrix.

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Authors and Affiliations

  1. Orthopädische Klinik, König-Ludwig-Haus, Universität Würzburg, Brettreichstraße 11, 97074, Würzburg, Deutschland

    U. Nöth, J. Reichert, S. Reppenhagen, A. Steinert, L. Rackwitz & J. Eulert

  2. Orthopädische Klinik, Asklepios Klinikum Bad Abbach, Universität Regensburg, Bad Abbach, Deutschland

    J. Beckmann & M. Tingart

Authors
  1. U. Nöth
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  2. J. Reichert
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  3. S. Reppenhagen
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  4. A. Steinert
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  5. L. Rackwitz
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  6. J. Eulert
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  7. J. Beckmann
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  8. M. Tingart
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Correspondence to U. Nöth.

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Nöth, U., Reichert, J., Reppenhagen, S. et al. Zellbasierte Therapie der Femurkopfnekrose. Orthopäde 36, 466–471 (2007). https://doi.org/10.1007/s00132-007-1087-2

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  • DOI: https://doi.org/10.1007/s00132-007-1087-2

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