PURPOSE: The purpose of our study is to describe the rationale, the surgical technique and the early clinical and radiographic results of the treatment of patients with early stage osteonecrosis of the femoral head (ONFH) by performing: core decompression, injection of autologous bone marrow concentrate and the use of a new composite injectable bone substitute (PRO-DENSE(®)), as a mechanical supplementation associated with decompression. METHODS: The study included 37 hips (31 patients, 14 females, 17 males; mean age 43.9 years, range 24-56 years) with stages IC-IIIA ONFH. The outcome was determined by the changes in the Harris hip score (HHS), by progression in radiographic stages and by the need for hip replacement. The mean follow-up was 20.6 months (range 12-32 months). RESULTS: At final follow-up the mean HHS increased from 68 points pre-operatively to 86 points post-operatively. The radiological results showed that 29 hips (78.4 %) improved or had no further collapse. The overall clinical success rate of the procedure was 86.5 %, with three conversions to THA, and a failure rate of only 3.3 % in the pre-collapse group. CONCLUSIONS: We are encouraged by these early results using core decompression, injection of the autologous bone marrow concentrate and backfilling the defect with an injectable bioceramic for the treatment of early stages of ONFH; as far as a conclusion can be drawn from the current data, this treatment seems to relieve hip pain and prevent the progression of ONFH in the majority of the cases.
PURPOSE: The purpose of our study is to describe the rationale, the surgical technique and the early clinical and radiographic results of the treatment of patients with early stage osteonecrosis of the femoral head (ONFH) by performing: core decompression, injection of autologous bone marrow concentrate and the use of a new composite injectable bone substitute (PRO-DENSE(®)), as a mechanical supplementation associated with decompression. METHODS: The study included 37 hips (31 patients, 14 females, 17 males; mean age 43.9 years, range 24-56 years) with stages IC-IIIA ONFH. The outcome was determined by the changes in the Harris hip score (HHS), by progression in radiographic stages and by the need for hip replacement. The mean follow-up was 20.6 months (range 12-32 months). RESULTS: At final follow-up the mean HHS increased from 68 points pre-operatively to 86 points post-operatively. The radiological results showed that 29 hips (78.4 %) improved or had no further collapse. The overall clinical success rate of the procedure was 86.5 %, with three conversions to THA, and a failure rate of only 3.3 % in the pre-collapse group. CONCLUSIONS: We are encouraged by these early results using core decompression, injection of the autologous bone marrow concentrate and backfilling the defect with an injectable bioceramic for the treatment of early stages of ONFH; as far as a conclusion can be drawn from the current data, this treatment seems to relieve hip pain and prevent the progression of ONFH in the majority of the cases.
Authors: David R Marker; Thorsten M Seyler; Slif D Ulrich; Siddharth Srivastava; Michael A Mont Journal: Clin Orthop Relat Res Date: 2008-04-08 Impact factor: 4.176
Authors: Robert M Urban; Thomas M Turner; Deborah J Hall; Nozomu Inoue; Steven Gitelis Journal: Clin Orthop Relat Res Date: 2007-06 Impact factor: 4.176
Authors: Roberto Civinini; Antonio Capone; Christian Carulli; Fabrizio Matassi; Lorenzo Nistri; Massimo Innocenti Journal: J Mater Sci Mater Med Date: 2017-08-07 Impact factor: 3.896
Authors: Tegan L Cheng; Ciara M Murphy; Laurence C Cantrill; Kathy Mikulec; Clare Carpenter; Aaron Schindeler; David G Little Journal: Int Orthop Date: 2014-01-04 Impact factor: 3.075
Authors: Andrzej Sionek; Adam Czwojdziński; Jacek Kowalczewski; Tomasz Okoń; Dariusz Marczak; Marcin Sibiński; Marcin Złotorowicz; Jarosław Czubak Journal: Int Orthop Date: 2018-03-17 Impact factor: 3.075