Abstract
Avascular necrosis of the femoral head (AVN) is a common cause of hip disability that, if left untreated, may cause collapse of femoral head and secondary hip osteoarthritis in up to 80% of patients. Osteonecrosis of the femoral head typically affects patients in their third-to-fifth decades of life and often, in 50% of these patients, the disease will develop on both sides.
Risk factors are many, such as hip trauma, alcohol abuse, excessive use of corticosteroids, hemoglobinopathy, Gaucher’s disease, pregnancy, coagulopathies, Caisson disease, inflammatory or autoimmune disease, antiretroviral therapy, hyperbaric exposure, cancer, smoke, chemotherapy.
Often a real risk factor for AVN cannot be found, and the disease is defined idiophatic osteonecrosis. The surgical treatment of our choice consists in the removal of necrotic tissue (core decompression) associated with the inclusion of growth factors (rh-BMP-7) and a “scaffold” of equine flexible bone enriched with autologous mesenchymal stromal cells. The objective of this technique is to create a biological chamber inside the femoral head, leading to the formation of a biological reactor capable of regenerating healthy bone tissue. This procedure is performed with a minimally invasive technique in the operating room, with the aid of a c-arm fluoroscope.
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Mazzola, S., Colombo, M., Mazza, E. et al. Osteonecrosi avascolare della testa del femore trattata con tecnica mini-invasiva: case report. Arch Ortop Reumatol 124, 32–33 (2013). https://doi.org/10.1007/s10261-013-0054-1
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DOI: https://doi.org/10.1007/s10261-013-0054-1