Retrospective Study on Implantation of Autologous-Cultured Osteoblasts for the Treatment of Patients with Avascular Necrosis of the Femoral Head.

IF 1.7 Q2 ORTHOPEDICS

Orthopedic Research and Reviews Pub Date : 2021-02-03 eCollection Date: 2021-01-01 DOI:10.2147/ORR.S281030

Gauresh Palekar, H P Bhalodiya, Shreedhar Archik, Kalpesh Trivedi

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引用次数: 6

Abstract

Purpose: Osteonecrosis of the femoral head is a progressive and debilitating disease that causes pain, osteoarthritis and hip joint collapse, eventually necessitating hip replacement. This study evaluated the long-term outcomes of autologous adult live-cultured osteoblasts (AALCO) implantation in patients with osteonecrosis of femoral head.

Patients and methods: In this retrospective multicenter study, we collated and analyzed data of patients ≥12 years of age who underwent AALCO (OSSGROW^®) between 2010 and 2015 for the treatment of osteonecrosis of the femoral head.

Results: Data from 64 patients (101 hip joints) were assessed in this study. The mean ±SD duration of disease since diagnosis of osteonecrosis was 7.4±1.6 years. The mean follow-up duration was 6.3±1.4 years. The mean VAS score (n=98 hips) reduced significantly from 58.8 ± 13.8 to 32.2 ± 32.1 post-operatively (mean difference: -26.5±35.2, p=0.001) and Harris hip score (n=97 hips) also significantly improved from 47.1±12.3 to 63.7±27.7 post-operatively (mean difference:16.7±28.7, p=0.0001). Following the AALCO treatment, 29 hips in 13 patients (28.7%) underwent total hip replacement (THA), indicating that AALCO treatment could delay THA for 71.3% of hips. A total of 39.1% of hips diagnosed in early stage versus 60.8% in the late stage of osteonecrosis required THA. Overall, 60.4% of hips improved, 2% remained stable, and 37.6% progressed following the AALCO implantation. The condition of disease was found to have improved in 71.1% of patients in early stage (Grades I and II) versus 58% in the late stage (Grades III and IV) of osteonecrosis.

Conclusion: Patients with osteonecrosis who received implantation of autologous-cultured osteoblasts using AALCO showed improvement in joint function and decrease in pain. Treatment with AALCO halted progression of osteonecrosis, preserved the natural hip, and eliminated the need for hip replacement surgeries in 7 out of 10 patients.

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自体培养成骨细胞植入治疗股骨头缺血性坏死的回顾性研究。

目的:股骨头坏死是一种进行性和衰弱性疾病，可引起疼痛、骨关节炎和髋关节塌陷，最终需要髋关节置换术。本研究评估了成人活体培养成骨细胞(AALCO)植入术治疗股骨头坏死患者的长期疗效。患者和方法:在这项回顾性多中心研究中，我们整理和分析了2010年至2015年间接受AALCO (OSSGROW®)治疗股骨头坏死的≥12岁患者的数据。结果:本研究评估了64例患者(101个髋关节)的数据。自诊断为骨坏死以来的平均±SD病程为7.4±1.6年。平均随访时间为6.3±1.4年。平均VAS评分(n=98髋)从58.8±13.8术后显著降低到32.2±32.1(平均差值:-26.5±35.2,p=0.001)， Harris髋关节评分(n=97髋)也从47.1±12.3术后显著提高到63.7±27.7(平均差值:16.7±28.7,p=0.0001)。在AALCO治疗后，13例患者中29髋(28.7%)行全髋关节置换术(THA)，表明AALCO治疗可以延迟71.3%髋关节的THA。在早期诊断为骨坏死的髋关节中，39.1%需要THA，而在晚期诊断为骨坏死的髋关节中，60.8%需要THA。总体而言，60.4%髋部改善，2%髋部保持稳定，37.6%髋部进展。71.1%的早期(I级和II级)骨坏死患者的疾病状况得到改善，而58%的晚期(III级和IV级)骨坏死患者的疾病状况得到改善。结论:骨坏死患者应用AALCO植入自体成骨细胞后，关节功能得到改善，疼痛减轻。在10例患者中，有7例采用AALCO治疗，阻止了骨坏死的进展，保留了髋关节的自然状态，并消除了髋关节置换手术的需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopedic Research and Reviews Medicine-Orthopedics and Sports Medicine

CiteScore

2.80

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Orthopedic Research and Reviews is an international, peer-reviewed, open-access journal focusing on the patho-physiology of the musculoskeletal system, trauma, surgery and other corrective interventions to restore mobility and function. Advances in new technologies, materials, techniques and pharmacological agents will be particularly welcome. Specific topics covered in the journal include: Patho-physiology and bioengineering, Technologies and materials science, Surgical techniques, including robotics, Trauma management and care, Treatment including pharmacological and non-pharmacological, Rehabilitation and Multidisciplinarian care approaches, Patient quality of life, satisfaction and preference, Health economic evaluations. The journal welcomes submitted papers covering original research, basic science and technology, clinical studies, reviews and evaluations, guidelines, expert opinion and commentary, case reports and extended reports.