Use of concentrated bone marrow aspirate and platelet rich plasma during minimally invasive decompression of the femoral head in the treatment of osteonecrosis

John R. Martin, Matthew T. Houdek, Rafael J. Sierra

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

The aim of this paper is to describe our surgical procedure for the treatment of osteonecrosis of the femoral head using a minimally invasive technique. We have limited the use of this procedure for patients with pre-collapse osteonecrosis of the femoral head (Ficat Stage I or II). To treat osteonecrosis of the femoral head at our institution we currently use a combination of outpatient, minimally invasive iliac crest bone marrow aspirations and blood draw combined with decompressions of the femoral head. Following the decompression of the femoral head, adult mesenchymal stem cells obtained from the iliac crest and platelet rich plasma are injected into the area of osteonecrosis. Patients are then discharged from the hospital using crutches to assist with ambulation. This novel technique was utilized on 77 hips. Sixteen hips (21%) progressed to further stages of osteonecrosis, ultimately requiring total hip replacement. Significant pain relief was reported in 86% of patients (n = 60), while the rest of patients reported little or no pain relief. There were no significant complications in any patient. We found that the use of a minimally invasive decompression augmented with concentrated bone marrow and platelet rich plasma resulted in significant pain relief and halted the progression of disease in a majority of patients.

Original languageEnglish (US)
Pages (from-to)219-224
Number of pages6
JournalCroatian Medical Journal
Volume54
Issue number3
DOIs
StatePublished - 2013

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Platelet-Rich Plasma
Osteonecrosis
Thigh
Decompression
Bone Marrow
Pain
Hip
Therapeutics
Crutches
Adult Stem Cells
Hip Replacement Arthroplasties
Mesenchymal Stromal Cells
Walking
Disease Progression
Outpatients

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Use of concentrated bone marrow aspirate and platelet rich plasma during minimally invasive decompression of the femoral head in the treatment of osteonecrosis. / Martin, John R.; Houdek, Matthew T.; Sierra, Rafael J.

In: Croatian Medical Journal, Vol. 54, No. 3, 2013, p. 219-224.

Research output: Contribution to journalArticle

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