क्लिनिकल परीक्षण जर्नल
खुला एक्सेस

अमूर्त

Functional Outcome of Autologous Bone Marrow Concentrate Implantation in Osteonecrosis of Femoral Head: A Two Year Follow-up Study

Venus Khanna, Madhan Jeyaraman, Shashank Goel and Manish Khanna

Background: Osteonecrosis of the femoral head is a progressive disease that generally affects patients in the third through fifth decades of life, if left untreated; it may lead to complete deterioration of the hip joint. The management of osteonecrosis of the femoral head differs with the stage of the disease and the activity. In this study, we tried to analyse clinically, radiologically and statistically the hips which received autologous bone marrow concentrate implantation along with core decompression. Materials and methods: An observational study was conducted at department of Orthopaedics, Hind Institute of Medical Sciences, Safedabad, Barabanki, Uttar Pradesh from October 2015 to August 2018. The patients with radiological confirmation of stage I, II or early III without collapse of osteonecrosis of femoral head were treated with core decompression and autologous bone marrow concentrate implantation. All patients were assessed clinically and radiologically for duration of 2 years. Results: A total of 10 patients and 13 hips were analysed with follow up period of 2 years to analyze the functional recovery with modified Harris hip score. We observed excellent results (mHHS ≥ 90) in 9 (69.2%) hips, good results (mHHS 80-89) in 2 (15.4%) hips, no improvement in 1 hip (7.7%) and 1 hip (7.7%) worsened at the end of 24 months. Radiographically, the hips showed no significant changes at the end of 6 months and increased sclerosis and mild hypertrophy at the margins of the femoral head at the end of 12 months. At 24 months, in 7 cases the femoral head slightly hypertrophied at the margins and assuming a slight ‘Umbrella’ shaped appearance. We reported no significant increase in pain in these seven hips after one year. The correlation analysis with Pearson’s correlation coefficient (r) was 0.81 which show highly positive correlation between BMAC and avascular necrosis of head of femur. There was a statistical significant difference between BMAC and avascular necrosis of head of femur (p<0.001) at the end of 2 year follow up. Conclusion: We conclude that autologous bone marrow concentrate implantation has a definitive and positive role towards the regeneration of head of femur in stage I, II and early III without collapse of osteonecrosis of femoral head.