Xu Yingxing, Jiang Yaping, Xia ChangSuo, Wang Yingzhen, Zhao Zhiping, Li Tao
Department of Joint Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China.
Qingdao University, Qingdao, Shandong, 266071, China.
Regen Ther. 2020 Nov 28;15:295-304. doi: 10.1016/j.reth.2020.11.003. eCollection 2020 Dec.
Osteonecrosis of the femoral head (ONFH) is a progressive disease with a complex etiology and unclear pathogenesis, resulting in severe hip pain and dysfunction mainly observed in young patients. Although total hip arthroplasty (THA) is the most effective treatment for patients with ONFH in the terminal stage, the results of THA in young patients or active populations are often not favorable, with some complications related to the prosthesis. With the development of biotechnology, an increasing number of studies pay attention to use of stem cells for the treatment of ONFH. Stem cells are characterized by the ability to self-renew and differentiate into multiple cell types, including differentiation into osteoblasts and endothelial cells to mediate bone repair and angiogenesis. Furthermore, stem cells can offer growth factors to promote blood supply in the necrotic regions by paracrine effects. Therefore, stem cell therapy has become one of the hip-preserving alternatives for ONFH. This review summarized the current trends in stem cell therapy for ONFH, from clinical applications to related basic research, and showed that an increasing number of studies have confirmed the effectiveness of stem cell therapy in ONFH. However, many unsolved problems and challenges in practical applications of stem cell therapy still exist, such as patient selection, standardized procedures, safety assessment, and the fate of transplanted cells in the body. Additional studies are required to find ideal cell sources, appropriate transplantation methods, and the optimal number of cells for transplantation.
股骨头坏死（ONFH）是一种病因复杂、发病机制不明的进行性疾病，主要表现为年轻患者严重的髋关节疼痛和功能障碍。虽然全髋关节置换术（THA）是终末期ONFH患者最有效的治疗方法，但在年轻患者或活跃人群中，THA的效果往往不尽人意，还会出现一些与假体相关的并发症。随着生物技术的发展，越来越多的研究关注干细胞在ONFH治疗中的应用。干细胞的特点是具有自我更新和分化为多种细胞类型的能力，包括分化为成骨细胞和内皮细胞以介导骨修复和血管生成。此外，干细胞可以通过旁分泌作用提供生长因子，促进坏死区域的血液供应。因此，干细胞治疗已成为ONFH保髋治疗的替代方法之一。本文综述了ONFH干细胞治疗的当前趋势，从临床应用到相关基础研究，表明越来越多的研究证实了干细胞治疗ONFH的有效性。然而，干细胞治疗在实际应用中仍存在许多未解决的问题和挑战，如患者选择、标准化程序、安全性评估以及移植细胞在体内的命运。还需要进一步研究以找到理想的细胞来源、合适的移植方法和最佳的移植细胞数量。
