Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA; Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.
Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Biomaterials. 2018 Dec;187:39-46. doi: 10.1016/j.biomaterials.2018.09.030. Epub 2018 Sep 20.
Osteonecrosis of the femoral head (ONFH) is a debilitating disease that may progress to femoral head collapse and subsequently, degenerative arthritis. Although injection of bone marrow-derived mononuclear cells (BMMCs) is often performed with core decompression (CD) in the early stage of ONFH, these treatments are not always effective in prevention of disease progression and femoral head collapse. We previously described a novel 3D printed, customized functionally-graded scaffold (FGS) that improved bone growth in the femoral head after CD in a normal healthy rabbit, by providing structural and mechanical guidance. The present study demonstrates similar results of the FGS in a rabbit steroid-induced osteonecrosis model. Furthermore, the injection of BMMCs into the CD decreased the osteonecrotic area in the femoral head. Thus, the combination of FGS and BMMC provides a new therapy modality that may improve the outcome of CD for early stage of ONFH by providing both enhanced biological and biomechanical cues to promote bone regeneration in the osteonecrotic area.
股骨头坏死（ONFH）是一种使人虚弱的疾病，可能会进展为股骨头塌陷，随后发展为退行性关节炎。尽管在 ONFH 的早期阶段经常进行骨髓来源的单核细胞（BMMCs）注射与核心减压（CD），但这些治疗方法并不总是有效预防疾病进展和股骨头塌陷。我们之前描述了一种新型的 3D 打印、定制的功能梯度支架（FGS），通过提供结构和机械引导，改善了 CD 后正常健康兔股骨头中的骨生长。本研究在兔类固醇诱导的骨坏死模型中证明了 FGS 的类似结果。此外，将 BMMCs 注射到 CD 中可减少股骨头中的骨坏死区域。因此，FGS 和 BMMC 的联合应用提供了一种新的治疗方式，通过提供增强的生物和生物力学线索，可能改善 CD 治疗早期 ONFH 的效果，促进骨坏死区域的骨再生。
