D'Ambrosi Riccardo, Biancardi Elena, Massari Giulia, Ragone Vincenza, Facchini Renato Mario
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
Centro Traumatologico Ortopedico, U.O. Clinica Ortopedica e Traumatologica, Milan, Italy.
Joints. 2018 Feb 12;6(1):16-22. doi: 10.1055/s-0038-1626740. eCollection 2018 Mar.
The aim of this study was to report the rate of survivorship in patients with osteonecrosis of the femoral head treated with core decompression in association with mesenchymal stem cells (MSCs) implantation, platelet-rich plasma (PRP) injection, and synthetic bone graft. We evaluated 24 hips in 16 patients, according to Ficat classification, treated by core decompression, injection of PRP and MSCs, and backfilling of the core tract with synthetic bone graft. Survivorship was estimated using Kaplan-Meier curves. The survivorship of core decompression in association with the procedure is 50% at 75 months of follow-up. The survival rate was 80% for patients in early stage and 28.6% for patients in advanced stage at 75 months. When we compared Kaplan-Meier survival curves of patients in stage III + IV and patients in stage I + II, we noticed that the survival functions are statistically different ( < 0.05, log-rank test), particularly in stage I + II where we had a greater surviving core decompression, in comparison to patients in stage III + IV. This technique is safe and good preliminary results were obtained in patients with early stages of the disease with no reported complications. Level IV, therapeutic case series.
本研究旨在报告采用髓芯减压联合间充质干细胞（MSCs）植入、富血小板血浆（PRP）注射及人工骨移植治疗的股骨头坏死患者的生存率。我们根据Ficat分类法评估了16例患者的24个髋关节，这些患者接受了髓芯减压、PRP和MSCs注射以及人工骨移植填充髓芯通道治疗。采用Kaplan-Meier曲线估计生存率。随访75个月时，髓芯减压联合该治疗方法的生存率为50%。75个月时，早期患者的生存率为80%，晚期患者的生存率为28.6%。当我们比较III + IV期患者和I + II期患者的Kaplan-Meier生存曲线时，发现生存函数在统计学上存在差异（P < 0.05，对数秩检验），特别是在I + II期，与III + IV期患者相比，该期髓芯减压的生存率更高。该技术安全，在疾病早期患者中取得了良好的初步结果，且无并发症报告。IV级，治疗性病例系列。
