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: http://www.actaorthopaedica.be/acta/download/2015-3/09-Persiani%20et%20al.pdf
At Riordan Medical Institute, Our physicians perform a procedure for AVFNH that is similar to the one described in the Italian study. However, they augment the BMAC injection with an amniotic tissue product developed by Dr. Riordan. This product is a pliable tissue allograft (transplant) derived from human placental amnion, which contains over 100 growth factors and functions as a biologic structural matrix to facilitate and enhance tissue healing and repair. Its inclusion adds a new dimension to the tissue repair process that was successfully tested in Rome.
We perform core decompression with stem cell therapy at RMI and therefore, we are encouraged to see independent study results published that show the effectiveness of a similar procedure for patients with avascular necrosis of the femoral head.
For more information about BMAC and Amniotic Tissue Product treatment at RMI, please CLICK HERE.
If you are suffering from avascular osteonecrosis of the femoral head and would like to be evaluated for treatment at RMI, the first step is to complete an online medical history. Once we receive it, our staff will contact you to answer general questions and to guide you through the rest of the evaluation process, which usually requires recent MRI images and an MRI report.