A recent University of Rome study published in Acta Orhopaedica Belgica entitled “Stage-Related Results In Treatment Of Hip Osteonecrosis With Core-Decompression And Autologous Mesenchymal Stem Cells” reported that avascular hip necrosis patients treated with a combination of bone marrow aspirate concentrate (BMAC) and surgical core decompression experienced significant improvements that could delay or avoid the need for hip replacement.

Osteonecrosis is the death of bone tissue caused by lack of blood supply to the bone. Another name for osteonecrosis is avascular necrosis. Tiny breaks in the bone caused by avascular necrosis can eventually lead to bone collapse. If the bone is fractures or becomes dislocated, its blood supply can be cut off. Early stage avascular necrosis may be treated with a combination of physical therapy, however most people with avascular necrosis will eventually need surgery including total joint replacement.

Core decompression is surgical procedure that involves removing part of the inside of the bone to relieve pressure and allow new blood vessels to form.

BMAC contains mesenchymal stem cells and CD34+ stem cells. Mesenchymal stem cells have been shown to promote tissue growth including cartilage and CD34+ stem cells can promote tissue vascularization, thus increasing blood supply to new or damaged tissue.

The researchers studied 29 patients (31 total hips) with Stage I and Stage II avascular osteonecrosis of the femoral head (AVNFH). The femoral head is the “ball” end of the thigh bone that fits into the hip socket. Patients were followed-up for two years after their procedures.

After 2 years, 25 out of 31 hips showed a relief of symptoms and a resolution of the osteonecrosis. The researchers concluded, “…treatment of AVNFH with implantation of autologous concentrated MSCs is indicated for patients at Stage I and Stage II”. They went on to state, “Our results show a significant reduction of joint pain level, and this could take to a delay, or avoid the need, of hip replacement.” Another significant finding was the association of corticosteroid therapy to a larger chance of treatment failure.

The original publication can be found here:https://europepmc.org/article/med/26435234

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