Stemcelldoc's Weblog

January 16, 2010

Avascular Necrosis of Femoral Head

Avascular necrosis (also know as osteonecrosis)  is a disease in which bone death occurs.

While the exact cause is unknown there are known risk factors which include alcoholism, excessive steroid use, trauma and vascular compression.

Avascular  necrosis (AVN) primary affects shoulders, knees and hips with death of the bone.  In addition there is often degeneration of the joint articular surfaces which result in pain and restriction in range of motion.

The Regenexx procedure, which allows patients to use their stem cells has been used in the treatment of AVN of the hip. Instead of surgery patients had their own expanded mesenchymal stem cells into the area of necrosis in the bone via x-ray guidance.  The Regenexx procedure with much less downtime than even a surgical CORE decompression and certainly less invasive than a hip replacement surgery.

Preliminary review of the data was significant.  Of the 27 patients treated to date, 4 were lost to follow-up (couldn’t get outcome information), and 3 went on to hip replacements so their data was removed as any results might be due to the hip replacement.  All patients were between 3 months and more than a year out from their stem cell injection.  Of the 20 remaining patients, approximate mean reported improvement was 50%.  This data requires more work.   We will be examining outcomes with regard to the disease severity( ARCO grade I, II, III, IV).  More to follow.

February 8, 2009

Avascular Necrosis

Avascular Necrosis (AVN) is an unfortunate disease where the blood supply to the hip bone (femoral head) is disrupted with loss of bone integrity and eventual collapse of the femoral head and joint. femoral-head

Trauma, use of steroids, alcohol abuse, damage from radiation, high blood pressure and sickle cell anemia have all been identified as causative factors.   Unfortunately the cause is often never identified.   AVN is also known as osteonecrosis, aseptic bone necrosis and ischemic bone necrosis. It affects people between 30 and 50 years of age.

Diagnosis is typically made by MRI which demonstrates areas of bone necrosis.  Collapse of subchondral bone is referred to as a crescent sign and is indicative of advanced disease.mri-of-avn

The most common treatment of  avascular necrosis of the femoral head is total hip replacement. Other treatments include core decompression, where the internal bone pressure is relieved by drilling a hole into the head of the femur.  Gangji demonstrated that injection of bone marrow mononuclear cells can reduce the progression of the disease when performed during the early stages of AVN.  Centeno et. al., in a single case study demonstrated articular surface regeneration  following the intra- articular  injection of bone marrow cells.

Combining bone marrow cells with stem cells is new novel technique.  The Centeno-Schultz Clinic offers a needle-in, needle-out treatment with mononucleated bone marrow cells alone or in combination with expanded mesenchymal stem cells for treatment of early stage avascular necrosis.

avasclarnecrosis.AVN.ostoenecrosis.Regenexx.cell stem therapy for AVN.

%d bloggers like this: