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Implantation of Culture-Expanded Bone Marrow Derived Mesenchymal Stromal Cells for Treatment of Osteonecrosis of the Femoral Head

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Tissue Engineering and Regenerative Medicine Aims and scope

Abstract

Background:

Although core decompression (CD) with stem cell for the treatment of osteonecrosis of the femoral head (ONFH) showed promising results in many reports, the efficacy remains uncertain. We aimed to evaluate the efficacy of CD with culture-expanded autologous bone marrow-derived mesenchymal stem cell (BM-MSC) implantation in early stage ONFH.

Methods:

A total of 18 patients (22 hips) with ONFH who underwent CD with culture-expanded BM-MSC implantation from September 2013 to July 2020 were retrospectively reviewed. The median age was 35.0 years [interquartile range (IQR), 28.5–42.0], and the median follow-up period was 4.0 years (IQR, 2.0–5.3). The median number of MSCs was 1.06 × 108. To evaluate radiographic and clinical outcomes, Association Research Circulation Osseous (ARCO) classifications, Japanese Investigation Committee classification, combined necrotic angle (CNA) visual analogue scale (VAS) and Harris Hip Score (HHS) were checked at each follow-up.

Results:

The preoperative stage of ONFH was ARCO 2 in 14 hips and ARCO 3a in 8 hips. The ARCO staging was maintained in 7 hips in ARCO 2 and 4 hips in ARCO 3a. The radiographic failure rate of ARCO 2 and 3a was 14.3 and 50%, respectively. Furthermore, CNA decreased to more than 20° in 6 hips (four were ARCO 2 and two were ARCO 3a).There was no significant difference in the VAS and HHS (P = 0.052 and P = 0.535, respectively). Total hip arthroplasty was performed in 4 hips.

Conclusion:

CD with culture-expanded autologous BM-MSCs showed promising results for the treatment of early stage ONFH.

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Data availability statement

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This research was supported by the Korean Fund for Regenerative Medicine (KFRM) grant funded by the Korea Government (the Ministry of Science and ICT, the Ministry of Health & Welfare), No. 22D0801L1 and No. 22C0604L1.

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Author notes

  1. Seong-Dae Yoon and Bum-** Shim equally contributed to the work and should be considered as co-first authors.

  2. Seung-Hoon Baek and Shin-Yoon Kim equally contributed to the work and should be considered as co-corresponding authors.

Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, Kyungpook National University, 130, Dongdeok-Ro, Jung-Gu, Daegu, 41944, South Korea

    Seong-Dae Yoon, Seung-Hoon Baek & Shin-Yoon Kim

  2. Department of Orthopedic Surgery, Kyungpook National University Hospital, 130, Dongdeok-Ro, Jung-Gu, Daegu, 41944, South Korea

    Seong-Dae Yoon, Seung-Hoon Baek & Shin-Yoon Kim

  3. Department of Orthopedic Surgery, Yeungnam University Hospital, College of Medicine, Yeungnam University, 170, Hyeonchung-ro, Nam-gu, Daegu, 42415, South Korea

    Bum-** Shim

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Contributions

Conceptualization: SHB, SYK. Data curation: S-DY, BJS. Formal analysis: BJS. Investigation: SDY, BJS. Methodology: SYK. Supervision: SYK. Validation: SHB, SYK. Visualization: BJS. Writing—original draft: SDY, BJS. Writing—review and editing: SDY, BJS.

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Correspondence to Shin-Yoon Kim.

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The study protocol was approved by the institutional review board of our hospital (IRB No. KNUH-2022-06-010-001). Informed consent was confirmed by the IRB.

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Yoon, SD., Shim, BJ., Baek, SH. et al. Implantation of Culture-Expanded Bone Marrow Derived Mesenchymal Stromal Cells for Treatment of Osteonecrosis of the Femoral Head. Tissue Eng Regen Med (2024). https://doi.org/10.1007/s13770-024-00647-z

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