Evidence for the Use of Cell-Based Therapy for the Treatment of Osteonecrosis of the Femoral Head- A Systematic Review of the Literature Commentary
Osteonecrosis of the femoral head (ONFH) occurs due to a defect in the blood supply to the femoral head. This inadequate supply leads to death of the subchondral bone and bone marrow and is the reason for approximately one in every ten hip replacements occurring most notably in young patients between the ages of 30 and 40 years. As cell-based therapies such as stem cells have become increasingly utilized in medicine, many studies begin to investigate whether these cell therapies have the power to restore the local cell population, establish effective bone remodeling, and ultimately avoid patients from needing a total hip replacement.
In order to determine how effective cell-therapies are in threating ONFH, this study performed a systematic review of the literature. The study determined that patients who received such therapies at early stages of ONFH had favorable patient-reported outcomes, a lower disease progression and failure rate, and successfully recovered with rare and minor complications. Additionally, studies indicate that cell therapies may not only reduce progression of necrosis, but even regress the ONFH lesions. Such success was noted through radiographically, as less than 25% of hips that received biologic treatments showed progression as compared to 40% of controls studied. Overall, the literature reports that early use of cell-based therapies are a safe treatment option which provide a potential improvement in clinical outcomes and may be a viable procedure for younger patients who may wish to avoid replacing their hips early in life.
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Baig SA, Baig MN. Osteonecrosis of the Femoral Head: Etiology, Investigations, and Management. Cureus. 2018;10(8):e3171. Published 2018 Aug 21. doi:10.7759/cureus.3171