Role of bone marrow-derived mesenchymal stem cells in treatment avascular necrosis of femoral head

AJBM crossMark

 

American Journal of BioMedicine Volume 10, Issue 1, pages 25-34
Geraldine M. Zingoni 1, Pablo D.Castillo 1, Cynthia B. Aliperti 1, David J. Horst 2

 

Abstract

Avascular necrosis (AVN) of the femoral head (FH) is a debilitating and painful disease with multiple etiologic risk factors head shows an increasing tendency and most commonly affects younger or middle-aged adults. Fifty patients (55 hips) with stage I, II or III avascular necrosis of femoral head were treated by autologous Bone marrow-derived mesenchymal stem cells injection. The patients were followed up clinically and radiologically for a minimum of 2 years at baseline, three, six, 12, and 24 months. The functional outcome was assessed in terms of Harris hip score, and disease progression was assessed radiologically by comparing the preoperative and follow-up MRI at the end of 2 years. On 2-year follow-up, there was considerable improvement in the hip function as measured by the Harris hip score (p = 0.041). On MRI, there was a decrease in the size of the lesion in group A (p = 0.03). Our findings showed that autologous Bone marrow-derived mesenchymal stem cells in avascular necrosis of femoral head is a safe and effective procedure and has better outcome.

Keywords: Avascular necrosis; Stem cell therapy; Bone marrow-derived mesenchymal stem cells

Copyright © 2022 by American Journal of BioMedicine, Inc.

Article citationReferencesFull-Text/PDFBecome reviewer
The citation data is computed by the following citation measuring services:

Cited by (CrossRef)
Google Scholar

  1. Feng Y, Yang SH, Xiao BJ, Xu WH, Ye SN, Xia T. Decreased in the number and function of circulation endothelial progenitor cells in patients with avascular necrosis of the femoral head. Bone. 2010; 46:32-40.
    https://doi.org/10.1016/j.bone.2009.09.001
  2. Hartley WT, McAuley JP, Culpepper WJ, Engh CA, Jr, Engh CA, Sr. Osteonecrosis of the femoral head treated with cementless total hip arthroplasty. J Bone Joint Surg Am. 2000; 82:1408-1413.
    https://doi.org/10.2106/00004623-200010000-00006
  3. Li ZH, Hu H, Zhang XY, Liu G.D, Ran B, Zhang PG. MiR-291a-3p regulates the BMSCs differentiation via targeting DKK1 in dexamethasone-induced osteoporosis. Kaohsiung J Med Sci. 2020; 36:35-42.
    https://doi.org/10.1002/kjm2.12134
  4. Kuang MJ, Huang Y, Zhao XG, Zhang R, Ma JX, Wang DC. Exosomes derived from Wharton's jelly of human umbilical cord mesenchymal stem cells reduce osteocyte apoptosis in glucocorticoid induced osteonecrosis of the femoral head in rats via the miR-21-PTEN-AKT signalling pathway. Int J Biol Sci. 2019; 15:1861-1871.
    https://doi.org/10.7150/ijbs.32262
  5. Peng W, Dong W, Zhang F, Wang J, Zhang J, Wu J. Effects of transplantation of FGF-2-transfected MSCs and XACB on TNF-α expression with avascular necrosis of the femoral head in rabbits. Biosci Rep. 2019; 39:1-10.
    https://doi.org/10.1042/BSR20180765
  6. Gangji V, Hauzeur JP, Matos C, De Maertelaer V, Toungouz M, Lambermont M. Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells. A pilot studies. J Bone Joint Surg Am. 2004; 86:1153-1160.
    https://doi.org/10.2106/00004623-200406000-00006
  7. Hauzeur JP, De Maertelaer V, Baudoux E, Malaise M, Beguin Y, Gangji V. Inefficacy of autologous bone marrow concentrate in stage three osteonecrosis: a randomized controlled double-blind trial. Int Orthop. 2017; 7:1429-1435.
    https://doi.org/10.1007/s00264-017-3650-8
  8. Houdek MT, Wyles CC, Collins MS, Howe BM, Terzic A, Behfar A. Stem cells combined with platelet-rich plasma effectively treat corticosteroid-induced osteonecrosis of the hip: a prospective study. Clin Orthop Relat Res. 2018; 476:388-397.
    https://doi.org/10.1007/s11999.0000000000000033
  9. Gangji V, Hauzeur JP. Treating osteonecrosis with autologous bone marrow cells. Skeletal Radiol. 2010; 39:209-211.
    https://doi.org/10.1007/s00256-009-0800-0
  10. Hernigou P, Beaujean F. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop Relat Res. 2002; 405:14-23.
    https://doi.org/10.1097/00003086-200212000-00003
  11. Houdek MT, Wyles CC, Packard BD, Terzic A, Behfar A, Sierra RJ. Decreased osteogenic activity of mesenchymal stem cells in patients with corticosteroid-induced osteonecrosis of the femoral head. J Arthroplasty. 2016; 31:893-898.
    https://doi.org/10.1016/j.arth.2015.08.017
  12. Bjorkman A, Svensson PJ, Hillarp A et al. Factor V Leiden and prothrombin gene mutation. Clinical Orth Relat Res 2004; 425:168-172.
    https://doi.org/10.1097/00003086-200408000-00023
  13. Kanthan SR, Kavitha G, Addi S, Choon DS, Kamarul T. Platelet-rich plasma (PRP) enhances bone healing in non-united critical-sized defects: a preliminary study involving rabbit models. Injury. 2011; 42:782-789.
    https://doi.org/10.1016/j.injury.2011.01.015
  14. Mont MA, Zywiel MG, Marker DR, McGrath MS, Delanois RE. The natural history of untreated asymptomatic osteonecrosis of the femoral head: a systematic literature review. J Bone Joint Surg Am. 2010; 92:2165-2170.
    https://doi.org/10.2106/JBJS.I.00575
  15. Hernigou P, Trousselier M, Roubineau F et al. Stem cell therapy for the treatment of hip osteonecrosis: A 30-year review of progress. Clin Orthop Surg 2016; 8:1-8.10.
    https://doi.org/10.4055/cios.2016.8.1.1
  16. Hernigou P, Beaujean F. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop. 2002; 405:14-23.
    https://doi.org/10.1097/00003086-200212000-00003
  17. Rastogi S, Sankineani SR, Nag HL, Mohanty S, Shivanand G, Marimuthu K, Kumar R, Rijal L. Intralesional autologous mesenchymal stem cells in management of osteonecrosis of femur: a preliminary study. Musculoskelet Surg. 2013; 97:223-228.
    https://doi.org/10.1007/s12306-013-0273-0
  18. Tripathy SK, Goyal T, Sen RK. Management of femoral head osteonecrosis: Current concepts. Indian J Orthop. 2015; 49(1): 28-45.
    https://doi.org/10.4103/0019-5413.143911
  19. Ming C, Min D, Yin Z. Isolation and culture of human bone marrow mesenchymal stem cells and induction of its differentiating into osteo- blasts in vitro. Orthop J of China. 2012; (01): 72-4.
  20. Zalavras C, Lieberman J. Osteonecrosis of the femoral head: evaluation and treatment. J Am Acad Orthop Surg. 2014; 22:455-64.
    https://doi.org/10.5435/JAAOS-22-07-455
  21. Glueck CJ, Freiberg RA, Wang P. Heritable thrombophilia-hypofibrinolysis and osteonecrosis of the femoral head. Clinical Orth Relat Res. 2008; 466:1034-1040.
    https://doi.org/10.1007/s11999-008-0148-0
  22. Makihara T, Yoshioka T, Sugaya H et al. Autologous concentrated bone marrow grafting for the treatment of osteonecrosis of the humeral head: A report of five shoulders in four cases. Case Rep Orthop. 2017; 2017:4898057.
    https://doi.org/10.1155/2017/4898057
  23. Daltro GC, Fortuna V, de Souza ES et al. Efficacy of autologous stem cell-based therapy for osteonecrosis of the femoral head in sickle cell disease: A five-year follow-up study. Stem Cell Res Ther. 2015; 6:18.
    https://doi.org/10.1186/s13287-015-0105-2
  24. Hernigou P, Homma Y, Flouzat-Lachaniette C, et al. Cancer Risk Is Not Increased in Patients Treated for Orthopaedic Diseases with Autologous Bone Marrow Cell Concentrate[J]. J Bone Joint Surg Am. 2013; 95(24):2215-21.
    https://doi.org/10.2106/JBJS.M.00261
  25. Tao W, Shihao Z, Jiyuan D. Status quo and argument of mesenchymal stem cell therapy for osteoarthritis[J]. Academic J Pla Postgraduate Med School. 2017; (06):559-61.
  26. Mont M, Cherian J, Sierra R, et al. Nontraumatic osteonecrosis of the femoral head: where do we stand today? A ten-year update. J Bone Joint Surg Am 2015; 97:1604-27.
    https://doi.org/10.2106/JBJS.O.00071
  27. Fellows C R, Matta C, Zakany R, et al. Adipose, bone marrow and synovial joint-derived mesenchymal stem cells for cartilage repair. Front Genet. 2016; 7:213.
    https://doi.org/10.3389/fgene.2016.00213
  28. Yuan H, Zhang J, Guo C, et al. Clinical outcomes of osteonecrosis of the femoral head after autologous bone marrow stem cell implantation: a meta-analysis of seven case-control studies. Clinics. 2016; 70(2): 110-3.
    https://doi.org/10.6061/clinics/2016(02)10
  29. Andriolo L, Merli G, Tobar C, et al. Regenerative therapies increase survivorship of avascular necrosis of the femoral head: A systematic review and meta-analysis. Int Orthop. 2018; 42(7): 1689-704.
    https://doi.org/10.1007/s00264-018-3787-0
  30. Tabatabaee RM, Saberi S, Parvizi J et al. Combining concentrated autologous bone marrow stem cells injection with core decompression improves outcome for patients with early-stage osteonecrosis of the femoral head: A comparative study. J Arthroplasty. 2015; 30:11-15.
    https://doi.org/10.1016/j.arth.2015.06.022
  31. Egger AC, Ballock RT. Osteonecrosis of the femoral head in an adolescent on long-term inhalational corticosteroids. Case Rep Pediatr. 2017; 2017;6969787.
    https://doi.org/10.1155/2017/6969787
  32. Lamb JN, Holton C, O'Connor P, Giannoudis PV. Avascular necrosis of the hip. Br Med J. 2019; 365:4.
    https://doi.org/10.1136/bmj.l2178
  33. Shah K, Racine J, Jones L, et al. Pathophysiology and risk factors for osteonecrosis. Curr Rev Musculoskelet Med. 2015; 8:201-9.
    https://doi.org/10.1007/s12178-015-9277-8
  34. Choi H, Steinberg M, Cheng E. Osteonecrosis of the femoral head: diagnosis and classification systems. Curr Rev Musculoskelet Med. 2015; 8:210-20.
    https://doi.org/10.1007/s12178-015-9278-7

Who Can Become a Reviewer?
Any expert in the article's research field can become a reviewer with American Journal of Biomedicine. Editors might ask you to look at a specific aspect of an article,...

Find out more

  • Research Article
    http://dx.doi.org/10.18081/2333-5106/2022.10/25
    American Journal of BioMedicine Volume 10, Issue 1, pages 25-34
    Received December 31, 2021; revised February 28, 2022; accepted March 19, 2022; published March 20, 2022.

    PDF Download this Paper

    How to cite this article
    Zingoni GMZ, Castillo PD, Aliperti CP, Horst DJ. Role of bone marrow-derived mesenchymal stem cells in treatment avascular necrosis of femoral head. American Journal of BioMedicine 2022;10(1):25-34.
    Case Study
    1. Abstract
    2. Introduction
    3. Methods and patients
    4. Results
    5. Discussion
    6. References

    Article metric