■股骨头坏死(ONFH),由于股骨头的血液供应受损,由于其衰弱的性质,对临床医生提出了重大挑战。保守治疗通常提供不充分的疼痛缓解和衰弱的功能结果,这需要替代疗法。骨髓穿刺液浓缩液(BMAC),一种有效的直系生物学,富含间充质基质细胞和生长因子,作为ONFH的微创手术具有良好的前景。随着前面的研究表明临床和功能疗效,我们评估了BMAC在联合保存ONFH管理中的治疗效果.
■对20例ONFH患者进行了一项前瞻性队列研究,这些患者对6个月的保守治疗无效。由一名外科医生进行统一的外科手术,涉及从髂前骨中提取骨髓,然后加工成8-10mL的BMAC浓缩物。然后将BMAC注射到植入减压的股骨头中。术后方案包括负重动员,物理治疗,和4周无NSAID方案。结果指标包括疼痛评分,髋关节功能,膝盖症状,体育活动,患者满意度,和程序的建议。
■在患有ONFH的20名患者中,主要是左边,大多数人都在2b阶段,在24个月内观察到显著的疼痛减轻和功能改善.平均疼痛评分从9.00下降到3.55,而髋关节功能评分从46.12上升到88.60。然而,一些患者遇到并发症,如症状复发(5%),疾病进展(10%),持续疼痛(5%)。
■带有BMAC植入的核心解压缩成为有希望的,有效,和ONFH的安全治疗,具有更好的成本效益和最小的副作用,使其成为可行的治疗替代方案。
UNASSIGNED: Osteonecrosis of the femoral head (ONFH), resulting from impaired blood supply to the head of the femur, presents a significant challenge to clinicians due to its debilitating nature. Conservative treatment often offers insufficient pain relief and debilitating functional outcomes which necessitate alternative therapies. Bone marrow aspirate concentrate (BMAC), a potent orthobiologics and rich in mesenchymal stromal cells and growth factors, holds good promise as the minimally invasive procedure for ONFH. With the preceding research suggesting clinical and functional efficacy, we assessed the therapeutic effectiveness of BMAC in ONFH management in joint preservation.
UNASSIGNED: A prospective cohort study was conducted with 20 patients suffering from ONFH who failed to respond to 6 months of conservative treatment. A uniform surgical procedure was performed by a single surgeon, involving bone marrow extraction from the anterior iliac crest and subsequent processing into an 8-10 mL of BMAC concentrate. The BMAC was then injected into the implanted into the decompressed femoral head. The post-operative protocol comprised weight-bearing mobilization, physiotherapy, and a 4-week NSAID-free regimen. Outcome measures included pain scores, hip function, knee symptoms, sports activities, patient satisfaction, and recommendation of the procedure.
UNASSIGNED: Of the 20 patients suffering from ONFH, primarily the left side, most of whom were at stage 2b, significant pain reduction and functional improvement were observed over 24 months. The mean pain score decreased from 9.00 to 3.55, while the hip function score increased from 46.12 to 88.60. However, some patients encountered complications such as symptom recurrence (5%), disease progression (10%), and persistent pain (5%).
UNASSIGNED: Core decompression with BMAC implantation emerges as a promising, effective, and safe treatment for ONFH with better costeffectiveness and minimal side effects, making it a feasible treatment alternative.