骨髓间充质干细胞移植联合髓芯减压植骨修复股骨头坏死

背景：单独使用髓芯减压治疗股骨头坏死，易造成股骨头凹陷和内部显微结构的崩溃，因而需要自体骨等材料进行填充支撑，而骨髓干细胞移植能使股骨头塌陷的发生率降低。目的：观察髓芯减压植骨联合骨髓间充质干细胞移植治疗股骨头坏死的临床效果。方法：选择2012年12月至2013年5月在沈阳医学院附属中心医院骨外四科住院的33例采用股骨头髓芯减压植骨联合骨髓间充质干细胞注入髓腔内治疗股骨头坏死患者。结果与结论：股骨头髓芯减压植骨联合骨髓间充质干细胞注入髓腔内治疗股骨头坏死后患者Harris髋关节功能评分增加，疼痛消失，能从事各种劳动；X射线片或CT检查显示股骨头正常30髋，占79%；疼痛明显减轻，行走基本正常或者轻微跛行15髋，占40%；行走间距延长35髋，占92%；髋关节功能障碍明显好转24髋，占63%。提示髓芯减压植骨联合骨髓间充质干细胞移植对改善股骨头缺血性坏死局部血供，促进坏死骨质吸收和骨质修复起到积极的作用。中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程全文链接：

Bone marrow mesenchymal stem cell transplantation combined with core decompression and bone grafting in the repair of osteonecrosis of femoral head

BACKGROUND: Core decompression alone for osteonecrosis of femoral head easily causes fovea of femoral head and collapse of inner microstructure. Therefore, autologous bone is needed for filling and supporting. Moreover, bone marrow stem cell transplantation can decrease the incidence of femoral head collapse. OBJECTIVE: To discuss the clinical effects of core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cells for osteonecrosis of femoral head. METHODS:A total of 33 patients were treated by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cells in the Fourth Department of Bone Surgery, Central Hospital Affiliated to Shenyang Medical College in China from December 2012 to May 2013. RESULTS AND CONCLUSION: After the treatment by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cells, Harris hip function score increased and pain disappeared in patients with osteonecrosis of femoral head. They could do various labors. Radiographs or CT examination displayed normal femoral head in 30 hips, accounting for 79%. Pain significantly reduced. Normal or slight limp walking was found in 15 hips, accounting for 40%. There were 35 hips in patients, whose walking distance was extended, accounting for 92%. 24 hips dysfunction was improved markedly, accounting for 63%. All results suggested that core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cells improved the local blood supply of femoral head, and played a positive role in promoting the necrotic bone absorption and bone repairing.