Stem Cells can Delay Total Hip Replacement (THR) in Avascular Necrosis | Orthopedic Associates

Stem Cells can Delay Total Hip Replacement (THR) in Avascular Necrosis

By John Urse, DO

Avascular necrosis of the hip is a condition of impaired blood supply to the top of the femur bone, or femoral head, which is the lower part of the hip joint. It can affect one or both hips at ages from 15-70, and is caused from trauma, alcohol excess, steroid use, and sometimes unknown (idiopathic) origins. Left untreated, over 80% of patients with involvement of over 10% of the femoral head area progress to THR within 2 years. MRI is useful for assessing the amount of damaged bone.

Traditional treatment for earlier stages of AVN involves drilling into the femoral head using Xray guidance, termed Core Decompression (CD). Later stages of collapse of the femoral head ( much like a dent in a ping pong ball), require replacement of the crumbled head with an artificial joint replacement, or THR. A review of 11 studies (1) for AVN of Femoral head in 507 patients showed adding Bone Marrow Concentrate with one’s own stem cells combined with Core Decom- pression (CD) was much more effective than CD alone.

Another prospective study (2) of Stage I and II Avascular necrosis of the femoral head indicated the need for total hip replacement at 5 years was reduced from 75% to 25%, when comparing CD and Stem Cells from BMC with CD alone. Improved pain and function scores, with reduction of the incidence of collapse of the roundness of the femoral head were also noted (3).

References:

Xu, et al: Biomed Research Int., 2017. Article ID 6136205

Gangi, V, et al; J Bone and Joint Surg, 2011, Nov. 49 (5): 1005-9

Hernigou, et al. CORR, 2002.

Learn More about Stem Cells and Dr. Urse on his website.

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