Ten-year results of concentrated autologous bone marrow aspirate transplantation for osteonecrosis of the femoral head: a retrospective study
Ten-year results of concentrated autologous bone marrow aspirate transplantation for osteonecrosis of the femoral head: a retrospective study
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DOI：
10.1186/s12891-019-2797-4
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发表时间：
2019-09-05
影响因子：
2.3
通讯作者：
Mishima, Hajime
中科院分区：
文献类型：
--
作者：
Tomaru, Yohei;Yoshioka, Tomokazu;Mishima, Hajime
特发性股骨头坏死（ONFH）发生在相对年轻的年龄。因此，重要的是要防止由此产生的股骨头塌陷和全髋关节置换术的要求，在这些患者。在2003年，我们开始了浓缩自体骨髓穿刺移植（CABMAT），关节保留治疗ONFH，在我们的机构。在这里，我们报告CABMAT治疗的长期结果。方法回顾性分析2003年4月至2008年4月采用CABMAT治疗的69例（109髋）特发性股骨头坏死患者的临床资料。结果44例患者（男21例，女23例，80髋）完成10年随访。随访率为73.4%，平均随访时间为12.0（范围，10.0-15.4）年。患者的平均年龄为42.2岁（范围：16.3-70.5）。使用协会研究循环骨（阿科）分类系统进行术前分析，分别有12、31、32和5个髋关节被分类为1、2、3和4期。转为全髋关节置换术（THA）的总比率为34%（27/80髋）。在多变量回归分析中，发现ONFH的术前分期和体重指数与转为THA显著相关。总共有43个髋关节（80个）被归类为属于塌陷前阶段（即，阶段1或2）。这些髋关节的总体塌陷率和THA转换率估计分别为49%（21/43）和14%（6/43）。结论根据我们的长期研究结果，微创可行的CABMAT疗法可作为保留关节的治疗ONFH的方法之一。
Background Idiopathic osteonecrosis of the femoral head (ONFH) occurs at a relatively younger age. It is therefore important to prevent the resultant femoral head collapse and requirement of total hip arthroplasty in these patients. In 2003, we initiated concentrated autologous bone marrow aspirate transplantation (CABMAT), a joint-preserving treatment for ONFH, at our institution. Here, we report the long-term results of CABMAT treatment. Methods We retrospectively collated and analyzed the demographic and treatment data of 69 patients (109 hips) with idiopathic ONFH treated with CABMAT between April 2003 and April 2008. Results Totally, 44 patients (21 men, 23 women, 80 hips) completed the 10-year follow-up. The follow-up rate was 73.4%, and the mean follow-up period was 12.0 (range, 10.0-15.4) years. The mean age of the patients was 42.2 (range, 16.3-70.5) years. Using the Association Research Circulation Osseous (ARCO) classification system for preoperative analysis, 12, 31, 32, and 5 hips were classified as stages 1, 2, 3, and 4, respectively. The overall rate of conversion to total hip arthroplasty (THA) was 34% (27/80 hips). In a multivariate regression analysis, the preoperative stage of ONFH and the body mass index were found to correlate significantly with conversion to THA. Totally, 43 hips (of 80) were classified as belonging to the pre-collapse stage (i.e., stages 1 or 2). The overall collapse rate and the THA-conversion rate of these hips were estimated to be 49% (21/43) and 14% (6/43), respectively. Conclusions On the basis of our long-term findings, the minimally invasive and feasible CABMAT therapy can be utilized as one of a joint-preserving treatment for ONFH.