Implantation of Culture-Expanded Bone Marrow Derived Mesenchymal Stromal Cells for Treatment of Osteonecrosis of the Femoral Head.

IF 4.4 4区医学 Q2 CELL & TISSUE ENGINEERING

Tissue engineering and regenerative medicine Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI:10.1007/s13770-024-00647-z

Seong-Dae Yoon, Bum-Jin Shim, Seung-Hoon Baek, Shin-Yoon Kim

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引用次数: 0

Abstract

Background: Although core decompression (CD) with stem cell for the treatment of osteonecrosis of the femoral head (ONFH) showed promising results in many reports, the efficacy remains uncertain. We aimed to evaluate the efficacy of CD with culture-expanded autologous bone marrow-derived mesenchymal stem cell (BM-MSC) implantation in early stage ONFH.

Methods: A total of 18 patients (22 hips) with ONFH who underwent CD with culture-expanded BM-MSC implantation from September 2013 to July 2020 were retrospectively reviewed. The median age was 35.0 years [interquartile range (IQR), 28.5-42.0], and the median follow-up period was 4.0 years (IQR, 2.0-5.3). The median number of MSCs was 1.06 × 10⁸. To evaluate radiographic and clinical outcomes, Association Research Circulation Osseous (ARCO) classifications, Japanese Investigation Committee classification, combined necrotic angle (CNA) visual analogue scale (VAS) and Harris Hip Score (HHS) were checked at each follow-up.

Results: The preoperative stage of ONFH was ARCO 2 in 14 hips and ARCO 3a in 8 hips. The ARCO staging was maintained in 7 hips in ARCO 2 and 4 hips in ARCO 3a. The radiographic failure rate of ARCO 2 and 3a was 14.3 and 50%, respectively. Furthermore, CNA decreased to more than 20° in 6 hips (four were ARCO 2 and two were ARCO 3a).There was no significant difference in the VAS and HHS (P = 0.052 and P = 0.535, respectively). Total hip arthroplasty was performed in 4 hips.

Conclusion: CD with culture-expanded autologous BM-MSCs showed promising results for the treatment of early stage ONFH.

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植入培养扩增的骨髓间充质基质细胞治疗股骨头骨坏死。

背景：尽管许多报道显示干细胞核心减压术（CD）治疗股骨头坏死（ONFH）效果良好，但疗效仍不确定。我们的目的是评估在早期股骨头坏死患者中植入培养扩增的自体骨髓间充质干细胞（BM-MSC）进行核心减压的疗效：回顾性分析2013年9月至2020年7月期间接受CD联合培养扩增自体骨髓间充质干细胞植入术的18例ONFH患者（22髋）。中位年龄为35.0岁[四分位距（IQR）为28.5-42.0]，中位随访时间为4.0年（IQR为2.0-5.3）。间充质干细胞的中位数为 1.06 × 108。为了评估放射学和临床结果，每次随访时都检查了骨关节研究协会（ARCO）分类、日本调查委员会分类、联合坏死角（CNA）视觉模拟量表（VAS）和哈里斯髋关节评分（HHS）：14个髋关节的ONFH术前分期为ARCO 2，8个为ARCO 3a。有 7 个处于 ARCO 2 期的髋关节和 4 个处于 ARCO 3a 期的髋关节维持了 ARCO 分期。ARCO 2 和 3a 的影像学失败率分别为 14.3% 和 50%。此外，6 个髋关节的 CNA 下降到 20° 以上（其中 4 个为 ARCO 2，2 个为 ARCO 3a），VAS 和 HHS 没有显著差异（分别为 P = 0.052 和 P = 0.535）。4个髋关节接受了全髋关节置换术：结论：使用培养扩增的自体骨髓间充质干细胞进行 CD 治疗早期 ONFH 有良好效果。

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来源期刊

Tissue engineering and regenerative medicine CELL & TISSUE ENGINEERING-ENGINEERING, BIOMEDICAL

CiteScore

6.80

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Tissue Engineering and Regenerative Medicine (Tissue Eng Regen Med, TERM), the official journal of the Korean Tissue Engineering and Regenerative Medicine Society, is a publication dedicated to providing research- based solutions to issues related to human diseases. This journal publishes articles that report substantial information and original findings on tissue engineering, medical biomaterials, cells therapy, stem cell biology and regenerative medicine.