Stem cell therapy for early stage osteonecrosis: challenges and future research directions

Over the past decade, several clinician researchers have started to evaluate the role of Mesenchymal stem cells (MSCs) in treatment of osteonecrosis (ON). Gangji et al. and Hernigou et al. have successfully used autologous bone marrow concentrate for treatment of early stage ON. Both investigators have reported midto long-term favorable results. However, contradictory results were also reported using similar techniques and patient populations. In addition, many questions are yet unanswered and only limited information is available in the literature in terms of clinical trials and surgical techniques in humans using MSCs as adjunct therapies. This manuscript will review literatures related to MSCutilizing surgical techniques and explore some of the limitations and future research directions of using stem cell therapies in osteonecrosis.