Hooda Aman, Kumar Deepak, Aggarwal Sameer, Thami Tarkik, Rana Anurag, Sahni Daisy
Department of Orthopaedics, PGIMER, Chandigarh, India.
Department of Anatomy, PGIMER, Chandigarh, India.
Indian J Orthop. 2022 Sep 22;56(12):2210-2213. doi: 10.1007/s43465-022-00752-y. eCollection 2022 Dec.
Core decompression supplemented by stem cell incorporation is an upcoming field of research in avascular necrosis of the femoral head. Plugging the canal to avoid loss of the concentrate injected has been recognized as a crucial step to improve the efficacy of the procedure. We describe a new surgical technique that results in native bone plug formation and eliminates the need for any additional blocker.
This pilot study was performed on 4 cadaveric proximal femurs. The standard technique was used for core decompression and bone marrow aspirate concentrate (BMAC) injection. Additionally, two more tracts were drilled, superolateral, and inferomedial to the primary tract.
No leakage of the radiopaque dye was observed from the entry point of the primary tract, ensuring its complete blockage in all 4 cadaveric proximal femurs. This was confirmed by sectioning the femur specimens which manifested bone plug formation at the confluence of the three tracts.
Our technique is a unique and economical method of preventing leakage of BMAC through the entry point in the proximal femoral metaphysis. This may not only benefit patients but can also provide the groundwork for further research in this field.
在股骨头缺血性坏死的研究领域，核心减压联合干细胞植入是一个新兴的研究方向。封堵骨隧道以避免注入的浓缩物流失，已被视为提高该手术疗效的关键步骤。我们描述了一种新的手术技术，该技术可形成天然骨塞，无需额外的封堵物。
本前瞻性研究在4具尸体的股骨近端进行。采用标准技术进行核心减压和骨髓抽吸浓缩物（BMAC）注射。此外，在主骨隧道的上外侧和下内侧再钻两个骨隧道。
在所有4具尸体的股骨近端，均未观察到不透射线染料从主骨隧道入口处漏出，确保了其完全封堵。通过对股骨标本进行切片检查证实，在三个骨隧道的交汇处形成了骨塞。
我们的技术是一种独特且经济的方法，可防止BMAC通过股骨近端干骺端的入口处漏出。这不仅可能使患者受益，还可为该领域的进一步研究奠定基础。
