Kouroupis Dimitrios, Ahari Amir F, Correa Diego, Shammaa Riam
Department of Orthopaedics, UHealth Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, FL, United States.
Canadian Centers for Regenerative Therapy, Toronto, ON, Canada.
Front Bioeng Biotechnol. 2020 Mar 20;8:202. doi: 10.3389/fbioe.2020.00202. eCollection 2020.
An 18-year-old female patient with Systemic Lupus Erythematosus (SLE) and corticosteroid-associated extensive bilateral symptomatic knee Osteonecrosis (ON) (Ficat IV), treated with sequential intralesional injections of autologous bone marrow aspirate concentrate (BMAC) under ultrasound guidance. At 3 months, pain was almost absent (VAS) and KOOS/WOMAC showed significant improvement sustained up to 24 months. At 12 months MRI indicated bone maturation, significantly reduced BM edema and subchondral fluid volume, and no collapse/fragmentation signs. The clinical and imaging significant improvement observed in this patient suggests that BMAC intralesional injections effectively restored the compromised bone structure. After larger studies, this technique can become an alternative to decompressing surgery for ON cases.
一名18岁的女性系统性红斑狼疮（SLE）患者，患有与皮质类固醇相关的双侧广泛性有症状性膝关节骨坏死（ON）（Ficat IV期），在超声引导下接受了自体骨髓抽吸浓缩物（BMAC）的序贯病灶内注射治疗。3个月时，疼痛几乎消失（视觉模拟评分法），膝关节损伤和骨关节炎疗效评分（KOOS）/西部安大略和麦克马斯特大学骨关节炎指数（WOMAC）显示出显著改善，且持续至24个月。12个月时，磁共振成像（MRI）显示骨成熟，骨髓水肿和软骨下液体量显著减少，且无塌陷/碎裂迹象。该患者观察到的临床和影像学显著改善表明，病灶内注射BMAC有效恢复了受损的骨结构。经过更大规模的研究后，该技术可成为ON病例减压手术的替代方法。
