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Early results of core decompression and autologous bone marrow mononuclear cells instillation in femoral head osteonecrosis: a randomized control study
Authors:Sen Ramesh Kumar  Tripathy Sujit Kumar  Aggarwal Sameer  Marwaha Neelam  Sharma Ratti Ram  Khandelwal Niranjan
Affiliation:Department of Orthopedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:Fifty-one osteonecrotic hips in 40 patients were randomly divided into 2 treatment groups. Patients in group A (25 hips) were treated with core decompression, and those in group B (26 hips) received autologous bone marrow mononuclear cell instillation into the core tract after core decompression. Outcome between the 2 groups were compared clinically (Harris Hip score), radiographically (x-ray and magnetic resonance imaging), and by Kaplan-Meier hip survival analysis after 12 and 24 months of surgical intervention. The clinical score and mean hip survival were significantly better in group B than in group A (P < .05). Patients with adverse prognostic features at initial presentation, that is, poor Harris Hip score, x-ray changes, edema, and/or effusion on magnetic resonance imaging had significantly better clinical outcome and hip survival in group B than in group A.
Keywords:avascular necrosis   bone marrow mononuclear cell   core decompression   osteonecrosis   femoral head   stem cell
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