Concentrated autologous bone marrow aspirate transplantation treatment for corticosteroid-induced osteonecrosis of the femoral head in systemic lupus erythematosus.
The purpose of this study was to evaluate concentrated autologous bone marrow aspirate transplantation (CABMAT) treatment for corticosteroid-induced osteonecrosis of the femoral head (ONFH) in systemic lupus erythematosus (SLE). Bone marrow was aspirated from iliac crests, concentrated on a conventional manual blood bag centrifugation technique that is used to extract buffy coats and then injected into nine hips with drilling. The mean number of nucleated cells for transplantation was 5.32 × 10(7) cells/ml. This cell concentration was significantly higher after concentration, and the mean concentration ratio was 5.5. At follow-up (minimum: three years), significant improvement in pain and Harris Hip Score was observed. For eight of nine hips, we successfully preserved the femoral head. However, one hip required total hip arthroplasty 45 months after the operation. CABMAT using our centrifugation technique is an effective, safe and low-cost procedure of therapeutic osteogenesis for corticosteroid-induced ONFH in SLE.
Department of Orthopaedic Surgery, Control of Musculoskeletal System, Advanced Biomedical Applications, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. tymd99@gmail.com
Tomokazu
T
Yoshioka
Hajime
H
Mishima
Hiroshi
H
Akaogi
Shinsuke
S
Sakai
Meihua
M
Li
Naoyuki
N
Ochiai
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced / Q000473:pathology* / Q000601:surgery; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D005938:Glucocorticoids