PMID- 36951976
OWN - NLM
STAT- MEDLINE
DCOM- 20230821
LR  - 20230913
IS  - 1432-5195 (Electronic)
IS  - 0341-2695 (Linking)
VI  - 47
IP  - 9
DP  - 2023 Sep
TI  - Clinical outcomes of autologous platelet-rich plasma and bone marrow mononuclear 
      cells grafting combined with core decompression for Association Research 
      Circulation Osseous II-IIIA stage non-traumatic osteonecrosis of the femoral 
      head.
PG  - 2181-2188
LID - 10.1007/s00264-023-05779-w [doi]
AB  - PURPOSE: This study aimed to investigate the efficacy and safety of autologous 
      platelet-rich plasma (PRP) and bone marrow mononuclear cells (BMMCs) grafting 
      combined with core decompression (CD) in the treatment of Association Research 
      Circulation Osseous (ARCO) II-IIIA stage non-traumatic osteonecrosis of the 
      femoral head (ONFH). METHODS: The clinical data of 44 patients (44 hips) with 
      non-traumatic ONFH from December 2018 to December 2019 were retrospectively 
      reviewed. Twenty-four patients underwent CD combined with autologous PRP and 
      BMMCs grafting (PRP+BMMCs group), and 20 patients underwent core decompression 
      alone (CD group). During a minimum follow-up of 36 months, radiographic outcomes 
      were evaluated using X-ray, radiographic failure rates were compared, and Harris 
      hip score (HHS) and visual analog scale (VAS) were selected to evaluate clinical 
      outcomes. The percentage of patients with minimal clinically important difference 
      (MCID) in both groups was analyzed. Clinical failure was defined as further total 
      hip arthroplasty (THA) with Kaplan-Meier survival analysis. Surgical 
      complications were recorded. RESULTS: All patients had well healed wounds, and no 
      complications such as infection and thrombosis occurred. HHS and VAS scores in 
      both the PRP+BMMCs and CD groups were better than those preoperatively (P<0.05). 
      At the last follow-up, the HHS and VAS scores of the PRP+BMMCs group were 
      significantly better than those of the CD group (P<0.05). In ARCO II-IIIA stage, 
      66.7% of the PRP+BMMCs group and 30.0% of the CD group achieved the MCID 
      (P<0.05). The clinical and imaging failure rates in the PRP+BMMCs group were 
      12.5% and 20.8%, respectively, compared with 40.0% and 50.0% in the CD group 
      (P<0.05). In ARCO II stage, the MCID, clinical and imaging failure rates of 
      PRP+BMMCs group and CD group were 66.7% and 33.3% (P<0.05), 4.8% and 33.3% 
      (P<0.05), 14.3% and 44.4% (P<0.05), respectively. The PRP+BMMCs group had better 
      hip survival rate compared with CD group (P<0.05). CONCLUSION: CD combined with 
      autologous PRP and BMMCs grafting is a safe and effective method for the 
      treatment of ARCO II-IIIA stage non-traumatic ONFH, especially for ARCO II stage, 
      effectively reducing the collapse rate of the femoral head and delaying or even 
      avoiding THA.
CI  - (c) 2023. The Author(s) under exclusive licence to SICOT aisbl.
FAU - Liang, Dawei
AU  - Liang D
AUID- ORCID: 0000-0003-0469-978X
AD  - Zhengzhou Medical Hospital District, Luoyang Orthopedic-Traumatological Hospital 
      of Henan Province (Henan Provincial Orthopedic Hospital), Zhengzhou, 450000, 
      China.
FAU - Pei, Jia
AU  - Pei J
AD  - Zhengzhou Medical Hospital District, Luoyang Orthopedic-Traumatological Hospital 
      of Henan Province (Henan Provincial Orthopedic Hospital), Zhengzhou, 450000, 
      China.
FAU - Zhang, Xiaohui
AU  - Zhang X
AD  - Zhengzhou Medical Hospital District, Luoyang Orthopedic-Traumatological Hospital 
      of Henan Province (Henan Provincial Orthopedic Hospital), Zhengzhou, 450000, 
      China.
FAU - Chen, Xiantao
AU  - Chen X
AD  - Luoyang Medical Hospital District, Luoyang Orthopedic-Traumatological Hospital of 
      Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, 471000, China. 
      yuetian7733@163.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230323
PL  - Germany
TA  - Int Orthop
JT  - International orthopaedics
JID - 7705431
SB  - IM
MH  - Humans
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - Femur Head/surgery
MH  - Bone Marrow/surgery
MH  - *Femur Head Necrosis/surgery
MH  - Decompression, Surgical/methods
MH  - Bone Transplantation
MH  - *Platelet-Rich Plasma
OTO - NOTNLM
OT  - Bone marrow mononuclear cells
OT  - Core decompression
OT  - Non-traumatic osteonecrosis of the femoral head
OT  - Platelet-rich plasma
EDAT- 2023/03/24 06:00
MHDA- 2023/08/21 06:43
CRDT- 2023/03/23 12:13
PHST- 2023/02/09 00:00 [received]
PHST- 2023/03/13 00:00 [accepted]
PHST- 2023/08/21 06:43 [medline]
PHST- 2023/03/24 06:00 [pubmed]
PHST- 2023/03/23 12:13 [entrez]
AID - 10.1007/s00264-023-05779-w [pii]
AID - 10.1007/s00264-023-05779-w [doi]
PST - ppublish
SO  - Int Orthop. 2023 Sep;47(9):2181-2188. doi: 10.1007/s00264-023-05779-w. Epub 2023 
      Mar 23.