Alternative head-preserving procedure for osteonecrosis of the femoral head: Tissue engineering, future perspective

초록

Osteonecrosis of the femoral head is the death of the cellular portion of the bone, with subsequent structural changes, leading to progressive collapse of the femoral head followed by degenerative arthritis of the hip joint and artificial joint replacement. Preservation of own femoral head instead of artificial implants especially in young patients with large involvement of head is the ideal goal. Vascularized bone grafting and transtrochanteric osteotomy had favorable results after long-term follow-up in lesions of medium to large size, weight-bearing portion located, and pre-collapsed necrosis. However, these procedures require very-high-demanding techniques, long operation time, and long-term rehabilitation period associated with unpredictable results and high rates of complications. We introduce a new tissue engineering technique using ex vivo culture-expanded bone marrow-derived stem cell seeding in calcium metaphosphate beads as an alternative minimal invasive procedure instead of technically challenging technique in challenging cases of osteonecrosis. © Springer Nature Switzerland AG 2021.

키워드