Stemcelldoc's Weblog

April 10, 2014

Avascular Necrosis of Femoral Head: Stem Cell Treatment Options

Avascular necrosis (AVN) is bone death thought to arise from interruption of the blood supply.  The MRI below illustrates bone death (AVN) in the left hip characterized by irregular shape of the femoral head and dark black bone.  This is in contrast to the normal hip on the right.

Avascular-necrosis-(AVN)2

 

Stem cell therapy is a non surgical option in the treatment of AVN of femoral head.

Core decompression is a x-ray guided procedure that places bone marrow derived stem cells directly into the area of necrosis.

Hernigou demonstrated the clinical efficacy of core decompression with bone marrow derived cells in the treatment of hip avascular necrosis.  534 patients with early stages of AVN were treated and best clinical outccomes were noted in patients without collapse of the femoral head (stage 3).

 Prior blog posts have discussed clincial successes.

Common causes of AVN include excessive alcohol, steroid use, trauma, vascular compression and chemotherapy.

Classical presentation involves the head of the femur, neck and talus and scaphoid.

Typically affects individuals between 30 and 50 years of age.

The two most commonly used classification system used are the Ficat andArlet Staging and ARCO staging.

AVN staging

A cardinal finding is the crescent sign which is seen on x-ray and refers to a linear area of subchondral lucency most frequently in the anterolateral aspect of the proximal femoral head.  The sign indicates a high likelihood of collapse.  The crescent sign is best seen in frog leg position (abduction).

crescent sign

Prognosis depends upon severity of the bone death.

Non surgical options utilizing bone marrow derived stem cells are available for patients with avascular necrosis at the Centeno-Schultz Clinic.

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