title: Treatment of AVN using the induction chamber technique and a biological-based approach: indications and clinical results.
abstract: OBJECTIVE
  To determine the efficacy of core decompression (CD) technique combined with recombinant morphogenetic proteins, autologous mesenchymal stem cells (MSCs) and xenograft bone substitute into the necrotic lesion of the femoral head on clinical symptoms and on the progression of osteonecrosis of the femoral head.
  
  
  METHODS
  A total of 38 patients (40 hips) with early stage osteonecrosis of the femoral head were studied over a 4-year period.
  
  
  RESULTS
  CD technique combined with recombinant morphogenetic proteins, autologous MSCs and xenograft bone substitute was associated with a significant reduction in both pain and joint symptoms and reduced the incidence of fractural stages. At 36 months, 33 patients achieved clinical and radiographic healing.
  
  
  CONCLUSIONS
  This long-term follow-up study confirmed that CD technique combined with recombinant morphogenetic proteins, autologous MSCs and xenograft bone substitute may be an effective treatment for patients with early stage osteonecrosis of the femoral head.
authors.affiliation: Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy. Electronic address: gmc@studiocalori.it.
authors.forename: G M
authors.initials: GM
authors.lastname: Calori
authors.affiliation: Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Mazza
authors.affiliation: Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Colombo
authors.affiliation: Orthopaedic Reparative Surgery Department, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Mazzola
authors.affiliation: University Department of Orthopaedics, Orthopaedic Institute Gaetano Pini, University of Milan, Italy.
authors.forename: G V
authors.initials: GV
authors.lastname: Mineo
authors.affiliation: Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds, UK.
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods*; D019299:Decompression, Surgical; D005260:Female; D005271:Femur Head Necrosis / Q000473:pathology* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D008875:Middle Aged; D010020:Osteonecrosis / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: AVN; Autologous implantation; Avascular necrosis; Biological chamber; Core decompression; Early stage; Femoral head; Mesenchymal stem cells; Osteonecrosis; rhBMP