Ten-year results of concentrated autologous bone marrow aspirate transplantation for osteonecrosis of the femoral head: a retrospective study.
Adolescent
Adult
Aged
Arthroplasty, Replacement, Hip
/ statistics & numerical data
Body Mass Index
Bone Marrow Transplantation
Female
Femur Head
/ pathology
Femur Head Necrosis
/ complications
Follow-Up Studies
Hip Joint
/ pathology
Humans
Male
Middle Aged
Organ Sparing Treatments
Retrospective Studies
Transplantation, Autologous
Treatment Outcome
Young Adult
Bone marrow aspirate concentrate
Hip preserving surgery
Osteonecrosis of the femoral head
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
05 Sep 2019
05 Sep 2019
Historique:
received:
17
05
2019
accepted:
28
08
2019
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
6
2
2020
Statut:
epublish
Résumé
Idiopathic osteonecrosis of the femoral head (ONFH) occurs at a relatively younger age. It is therefore important to prevent the resultant femoral head collapse and requirement of total hip arthroplasty in these patients. In 2003, we initiated concentrated autologous bone marrow aspirate transplantation (CABMAT), a joint-preserving treatment for ONFH, at our institution. Here, we report the long-term results of CABMAT treatment. We retrospectively collated and analyzed the demographic and treatment data of 69 patients (109 hips) with idiopathic ONFH treated with CABMAT between April 2003 and April 2008. Totally, 44 patients (21 men, 23 women, 80 hips) completed the 10-year follow-up. The follow-up rate was 73.4%, and the mean follow-up period was 12.0 (range, 10.0-15.4) years. The mean age of the patients was 42.2 (range, 16.3-70.5) years. Using the Association Research Circulation Osseous (ARCO) classification system for preoperative analysis, 12, 31, 32, and 5 hips were classified as stages 1, 2, 3, and 4, respectively. The overall rate of conversion to total hip arthroplasty (THA) was 34% (27/80 hips). In a multivariate regression analysis, the preoperative stage of ONFH and the body mass index were found to correlate significantly with conversion to THA. Totally, 43 hips (of 80) were classified as belonging to the pre-collapse stage (i.e., stages 1 or 2). The overall collapse rate and the THA-conversion rate of these hips were estimated to be 49% (21/43) and 14% (6/43), respectively. On the basis of our long-term findings, the minimally invasive and feasible CABMAT therapy can be utilized as one of a joint-preserving treatment for ONFH.
Sections du résumé
BACKGROUND
BACKGROUND
Idiopathic osteonecrosis of the femoral head (ONFH) occurs at a relatively younger age. It is therefore important to prevent the resultant femoral head collapse and requirement of total hip arthroplasty in these patients. In 2003, we initiated concentrated autologous bone marrow aspirate transplantation (CABMAT), a joint-preserving treatment for ONFH, at our institution. Here, we report the long-term results of CABMAT treatment.
METHODS
METHODS
We retrospectively collated and analyzed the demographic and treatment data of 69 patients (109 hips) with idiopathic ONFH treated with CABMAT between April 2003 and April 2008.
RESULTS
RESULTS
Totally, 44 patients (21 men, 23 women, 80 hips) completed the 10-year follow-up. The follow-up rate was 73.4%, and the mean follow-up period was 12.0 (range, 10.0-15.4) years. The mean age of the patients was 42.2 (range, 16.3-70.5) years. Using the Association Research Circulation Osseous (ARCO) classification system for preoperative analysis, 12, 31, 32, and 5 hips were classified as stages 1, 2, 3, and 4, respectively. The overall rate of conversion to total hip arthroplasty (THA) was 34% (27/80 hips). In a multivariate regression analysis, the preoperative stage of ONFH and the body mass index were found to correlate significantly with conversion to THA. Totally, 43 hips (of 80) were classified as belonging to the pre-collapse stage (i.e., stages 1 or 2). The overall collapse rate and the THA-conversion rate of these hips were estimated to be 49% (21/43) and 14% (6/43), respectively.
CONCLUSIONS
CONCLUSIONS
On the basis of our long-term findings, the minimally invasive and feasible CABMAT therapy can be utilized as one of a joint-preserving treatment for ONFH.
Identifiants
pubmed: 31488133
doi: 10.1186/s12891-019-2797-4
pii: 10.1186/s12891-019-2797-4
pmc: PMC6729020
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
410Références
Clin Orthop Relat Res. 1992 Apr;(277):111-20
pubmed: 1555330
Arthritis Rheum. 2011 Oct;63(10):3169-73
pubmed: 21953089
Clin Orthop Relat Res. 1989 Dec;(249):209-18
pubmed: 2582669
Clin Orthop Relat Res. 1978 Jan-Feb;(130):191-201
pubmed: 639389
Acta Orthop. 2016 Feb;87(1):72-8
pubmed: 26220203
J Bone Joint Surg Br. 1990 May;72(3):387-90
pubmed: 2341433
Int Orthop. 2018 Jul;42(7):1689-1704
pubmed: 29411077
Acta Orthop. 2008 Jun;79(3):445-8
pubmed: 18626810
J Bone Joint Surg Br. 2008 Jul;90(7):852-7
pubmed: 18591591
J Bone Joint Surg Br. 1995 Nov;77(6):870-4
pubmed: 7593097
Mod Rheumatol. 2015 Mar;25(2):278-81
pubmed: 25036228
Bone Marrow Res. 2018 Feb 25;2018:1549826
pubmed: 29682351
J Bone Joint Surg Am. 2008 Mar;90(3):477-84
pubmed: 18310696
World Rev Nutr Diet. 2005;94:1-12
pubmed: 16145245
J Bone Joint Surg Am. 2006 Dec;88(12):2565-72
pubmed: 17142405
N Engl J Med. 1992 May 28;326(22):1473-9
pubmed: 1574093
J Bone Joint Surg Am. 1997 Jul;79(7):1054-63
pubmed: 9234882
Clin Orthop Relat Res. 2004 Dec;(429):139-45
pubmed: 15577478
Bone. 2011 Nov;49(5):1005-9
pubmed: 21821156
Clin Orthop Relat Res. 1989 Jul;(244):198-207
pubmed: 2743660
J Epidemiol. 2015;25(6):437-44
pubmed: 25912097
Indian J Orthop. 2009 Jan;43(1):40-5
pubmed: 19753178
Int Orthop. 2016 Aug;40(8):1747-1754
pubmed: 26715504
J Bone Joint Surg Am. 1996 Jul;78(7):1032-8
pubmed: 8698720
Int Orthop. 2018 Jul;42(7):1739-1745
pubmed: 29796764
J Bone Joint Surg Br. 1993 Jul;75(4):597-601
pubmed: 8331115
J Bone Joint Surg Br. 1999 Mar;81(2):349-55
pubmed: 10204950
Int Orthop. 2018 Jul;42(7):1623-1630
pubmed: 29705871