التفاصيل البيبلوغرافية
| العنوان: |
Mid-term comparative outcomes of autologous bone-marrow concentration to treat osteonecrosis of the femoral head in standard practice. |
| المؤلفون: |
Cruz-Pardos, Ana1 anuskacp@yahoo.es, Garcia-Rey, Eduardo1, Ortega-Chamarro, Jose A.1, Duran-Manrique, David1, Gomez-Barrena, Enrique1 |
| المصدر: |
Hip International. Sep/Oct2016, Vol. 26 Issue 5, p432-437. 6p. |
| مصطلحات موضوعية: |
*FEMUR head, *AUTOGRAFTS, *BONE marrow, *OSTEONECROSIS, *CHI-squared test, *CONFIDENCE intervals, *FISHER exact test, *MAGNETIC resonance imaging, *ORTHOPEDIC surgery, *PROBABILITY theory, *REGRESSION analysis, *T-test (Statistics), *MULTIPLE regression analysis, *RETROSPECTIVE studies, *DATA analysis software, *KAPLAN-Meier estimator, *LOG-rank test, *MANN Whitney U Test, *SURGERY, SURGICAL complication risk factors |
| مستخلص: |
To evaluate mid-term effectiveness of core decompression (CD) followed by injection of bone-marrow concentration (BMC) in osteonecrosis of the femoral head (ONFH) compared with CD alone.~Purpose~Objective~We retrospectively studied 60 hips in 45 patients with ONFH Ficat I-II after a mean follow-up of 45 (range 24-171) months. Group A (19 hips) were treated with CD, and Group B (41 hips) with CD plus autologous BMC. Necrotic lesions were classified according to MRI findings in: (i) the lesion angle; and (ii) the relation of the necrotic area to the weight-bearing portion. Outcomes included clinical changes and radiographic femoral head collapse. Risk factors associated with radiological collapse were evaluated by Cox regression analysis.~Methods~Methods~Postoperative Merlé D´Aubigne and Postel hip score was similar in both groups. Femoral head collapse was observed in 10/19 hips in Group A and 22/41 in Group B. At 24 months, the probability of not having a collapse was 56.4% (95% CI, 33.6%-79.1%) for Group A and 57.6% (95% CI, 41.7%-73.4%) for Group B (p = 0.47). The risk of collapse increased in hips with a lesion angle higher than 150° (p<0.02, hazard risk [HR] 4.073) in both groups.~Results~Results~With the standard BMC technique performed without monitoring the number of progenitors in the concentrate, we are uncertain to observe a significant decrease in femoral head collapse compared to CD alone. Improved outcomes may require the monitoring of progenitor cells injected into the femoral head, particularly in large lesions.~Conclusions~Conclusions [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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