Autologous Bone Marrow Derived Cells With Core Decompression As Treatment Option For Avascular Necrosis Of The Femoral Head

Avascular necrosis of the femoral head (AVN) is a progressive pathological process resulting from disruption of blood supply to the femoral head and elevation of intraosseous pressure. Early stage AVN can be managed by various techniques, the results have been disappointing, total hip arthroplasty is frequently the only durable option for pain relief and restoration of function. The newer treatment modalities include using high stem cell concentration in the vicinity of the necrosed tissue with core decompression to prevent disease progression. Patients and methods: A single armed study done from October 2017 till February 2019, the total number of patients was 10, (5 Female 5 male). Etiology include corticosteroids use, systemic lupus erythematosus, sickle cell disease and idiopathic. The age of the patients range from 25-57 years. The procedure includes core decompression with autologous bone marrow derived mononuclear cell injection inside the hip joint space. Results: The results showed improvement in the Harris hip score from 48.7±6.6 to 88.00±4.6 (p＜0.001) in seven patients. With radiological proof by magnetic resonance imaging. Conclusions: This single arm short term study showed that core decompression with autologous bone marrow derived cell therapy is safe and effective method and it is a form of minimal manipulative treatment and merits such treatment in larger and longer term study.