Bone marrow from the iliac crest versus from the distal radius for revitalizing the necrotic lunate for Kienböck disease

Takeshi Ogawa, N. Ochiai, Y. Hara
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引用次数: 4

Abstract

We developed a technically simple procedure to revitalize the necrotic lunate for Kienböck disease using a combination of non-concentrated bone marrow (BM) transfusion from the radius to lunate, lowintensity pulsed ultrasound, and external fixation (Ogawa et al., 2013). The results were shown to be not inferior to those of conventional treatments for Kienböck disease (Ogawa et al., 2013). After 2007, our protocol was altered: non-concentrated BM from the iliac crest was used under the hypothesis that a greater number of BM cells would be advantageous to regenerate the necrotic lunate (Hernigou et al., 2005). We treated 16 patients (nine men and seven women) with Kienböck disease using the iliac crest as the BM donor site. Preoperative Lichtman stages were Stage II in five patients, Stage IIIa in six, and Stage IIIb in five. We performed the surgery in the same way as in our previous report (Ogawa et al., 2013), except that we collected the BM aspirate (approximately 5 mL) from the iliac crest (Figure 1). Mean age of the 16 patients at the surgery was 44 years (range 15–73); mean follow-up was 36 months (range 12–78). The length of external fixation was 69 Journal of Hand Surgery (European Volume) 2020, Vol. 45(3) 299–309 journals.sagepub.com/home/jhs
髂骨骨髓与桡骨远端骨髓对比用于修复Kienböck疾病坏死月骨
我们开发了一种技术简单的方法,通过从桡骨向月骨输注非浓缩骨髓(BM)、低强度脉冲超声和外固定相结合,使坏死的月骨复活,以治疗Kienböck病(Ogawa等人,2013)。结果显示,Kienböck病的治疗效果并不比传统治疗差(Ogawa等人,2013)。2007年后,我们的方案发生了变化:在假设更多的骨髓细胞有利于坏死的新月体再生的情况下,使用来自髂嵴的非浓缩骨髓(Hernigou等人,2005)。我们使用髂嵴作为BM供体部位治疗了16名Kienböck病患者(9名男性和7名女性)。术前Lichtman分期为II期5例,IIIa期6例,IIIb期5例。我们以与我们之前的报告(Ogawa等人,2013)相同的方式进行了手术,只是我们从髂嵴收集了BM吸出物(约5 mL)(图1)。16名手术患者的平均年龄为44岁(15-73岁);平均随访时间为36个月(12-78)。外固定长度为69 Journal of Hand Surgery(European Volume)2020,Vol.45(3)299–309 journals.sagepub.com/home/jhs
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