Gangji Valérie, Toungouz Michel, Hauzeur Jean-Philippe
Department of Rheumatology and Physical Medicine, Erasme University Hospital, Université Libre de Bruxelles, 808 route de Lennik, 1070 Bruxelles, Belgium.
Expert Opin Biol Ther. 2005 Apr;5(4):437-42. doi: 10.1517/14712598.5.4.437.
Aseptic non-traumatic osteonecrosis of the femoral head is a painful disorder of the hip that can lead to femoral head collapse and the need for total hip replacement. As osteonecrosis may be a disease of mesenchymal cells or bone cells, the possibility has been raised that bone marrow containing osteogenic precursors implanted into the necrotic lesion could be of benefit in this condition. Indeed, bone marrow contains adult stem cells, such as haematopoietic stem cells, mesenchymal stem cells and multipotent stem cells, that might have osteogenic properties. The efficacy of bone marrow implantation into the osteonecrotic zone was studied in two prospective trials. This treatment avoided the progression of the disease to the stage of the subchondral fracture (stage III) and reduced the need for total hip replacement. The mechanisms involved might include improved osteogenesis and angiogenesis. This new therapeutic approach should modify the treatment of early-stage osteonecrosis of the femoral head.
无菌性非创伤性股骨头坏死是一种髋关节疼痛性疾病，可导致股骨头塌陷并需要进行全髋关节置换。由于骨坏死可能是间充质细胞或骨细胞的疾病，因此有人提出，将含有成骨前体的骨髓植入坏死病灶可能对这种情况有益。事实上，骨髓含有成体干细胞，如造血干细胞、间充质干细胞和多能干细胞，它们可能具有成骨特性。两项前瞻性试验研究了将骨髓植入骨坏死区域的疗效。这种治疗避免了疾病发展到软骨下骨折阶段（III期），并减少了全髋关节置换的需求。其中涉及的机制可能包括改善成骨和血管生成。这种新的治疗方法应该会改变早期股骨头坏死的治疗方式。
