title: Osteonecrosis repair with bone marrow cell therapies: state of the clinical art.
abstract: BACKGROUND
  Hip osteonecrosis is a pathological condition resulting from cellular impairment due to reduction in osteoblast activity and local mesenchymal stem cell populations. Cell-based therapies might aid in overcoming these deficiencies by providing stem cells and other progenitor cells to potentially improve the local cellular environment in the affected hip.
  
  
  METHODS
  A PubMed search, using the search terms "hip osteonecrosis" and "mesenchymal stem cells", was conducted in December 2013. A total of 15 publications were identified and reviewed for clinical outcomes.
  
  
  RESULTS
  Clinical studies of patients with osteonecrosis treated with mesenchymal stem cells showed beneficial effects. No unexpected adverse events were identified in these studies. Core decompression was the usual method for autologous bone marrow cell implantation into the femoral head. However, other methods have been used such as arterial or venous delivery. A rationale for the use of cytotherapy, as well as the different descriptions of the techniques of implantation MSCs (autologous vs. allogenic, concentration vs. expansion), is provided in the context of treating hip osteonecrosis. Current problems and future challenges with cytotherapy and associated techniques are discussed. This article is part of a Special Issue entitled "Stem Cells and Bones".
authors.affiliation: Orthopaedic Surgery, University Paris East, Hôpital Henri Mondor, 94010 Creteil, France. Electronic address: philippe.hernigou@wanadoo.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hernigou
authors.affiliation: University Paris East, Hôpital Henri Mondor, 94010 Creteil, France.
authors.forename: Charles-Henri
authors.initials: CH
authors.lastname: Flouzat-Lachaniette
authors.affiliation: University Paris East, Hôpital Henri Mondor, 94010 Creteil, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Delambre
authors.affiliation: Orthopaedic Surgery, University Paris East, Hôpital Henri Mondor, 94010 Creteil, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Poignard
authors.affiliation: Orthopaedic Surgery, University Paris East, Hôpital Henri Mondor, 94010 Creteil, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Allain
authors.affiliation: EFS Cell Therapy Facility, University Paris East, Hôpital Henri Mondor, 94010 Creteil, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chevallier
authors.affiliation: EFS Cell Therapy Facility, University Paris East, Hôpital Henri Mondor, 94010 Creteil, France.
authors.forename: Helene
authors.initials: H
authors.lastname: Rouard
mesh_terms: D000818:Animals; D001854:Bone Marrow Cells / Q000166:cytology*; D002986:Clinical Trials as Topic; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000166:cytology; D010020:Osteonecrosis / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Bone marrow; Cytotherapy; Hip osteonecrosis; Mesenchymal stem cells; Osteonecrosis