Yamasaki T, Yasunaga Y, Ishikawa M, Hamaki T, Ochi M
Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
J Bone Joint Surg Br. 2010 Mar;92(3):337-41. doi: 10.1302/0301-620X.92B3.22483.
We have investigated the effectiveness of the transplantation of bone-marrow-derived mononuclear cells (BMMNCs) with interconnected porous calcium hydroxyapatite (IP-CHA) on early bone repair for osteonecrosis of the femoral head. We studied 22 patients (30 hips) who had osteonecrosis with a minimum follow-up of one year after implantation of BMMNCs. The mean age at surgery was 41 years (18 to 64) and the mean period of follow-up was 29 months (19 to 48). In a control group, cell-free IP-CHA was implanted into a further eight patients (9 hips) with osteonecrosis of the femoral head and the outcomes were compared. A reduction in the size of the osteonecrotic lesion was observed subsequent to hypertrophy of the bone in the transition zone in the BMMNC group. In three patients in the treatment group progression to extensive collapse was detected. In the control group subtle bone hypertrophy was observed, but severe collapse of the femoral head occurred in six of eight hips. In this limited study the implantation of BMMNCs and IP-CHA appears to confer benefit in the repair of osteonecrosis and in the prevention of collapse.
我们研究了骨髓来源的单个核细胞（BMMNCs）与相互连通的多孔羟基磷灰石（IP-CHA）联合移植对早期股骨头坏死骨修复的有效性。我们研究了22例患者（30髋），这些患者患有股骨头坏死，在植入BMMNCs后至少随访一年。手术时的平均年龄为41岁（18至64岁），平均随访时间为29个月（19至48个月）。在对照组中，将无细胞的IP-CHA植入另外8例（9髋）股骨头坏死患者体内，并比较结果。在BMMNC组中，观察到过渡区骨肥大后骨坏死病变大小减小。治疗组中有3例患者出现广泛塌陷进展。在对照组中观察到轻微的骨肥大，但8髋中有6髋发生了严重的股骨头塌陷。在这项有限的研究中，BMMNCs和IP-CHA的植入似乎在骨坏死修复和预防塌陷方面具有益处。
