Regenerative medicine for osteonecrosis of the femoral head: present and future

Bone & Joint Research

article

Gun-Il Im¹ 

[1] Research Institute for Convergence Life Science, Dongguk University

关键词: Regenerative medicine;    Treatment;    Osteonecrosis of the femoral head;    osteonecrosis of the femoral head (ONFH);    regenerative therapies;    cell-based therapy;    MSCs;    stem cells;    bone marrow aspirate concentrate (BMAC);    femoral head;    growth factors;    BMSCs;    osteogenic cells;   

DOI  :  10.1302/2046-3758.121.BJR-2022-0057.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

One of the notable exceptions to the paradigm of self-healing bone is osteonecrosisof the femoral head (ONFH). In this disease,obstruction of blood supply and increasedintraosseous pressure to the femoral headsubsequently cause death of osteocytes.Necrotic bone cannot continually repairitself, and consequently microfractures accumulate and progress to structural collapse.1The high incidence of ONFH in youngpatients (20 to 40years old), in particular, creates major treatment dilemmas.2While immediate good results of arthroplasty are appealing to both patients andsurgeons, the high chances of failure in thelong remaining lifespan justify attempts topreserve the femoral head. Therefore, regenerative medicine for bone regeneration findsa good niche in the treatment of ONFH.3Considering that the pathogenesis of ONFHis related to cell death, replenishing cellsthat can make bone or vasculature in situ isan appealing concept. Core decompressionprocedure, in which part of a necrotic boneis removed to alleviate pain and possibly curethe disease, provides unique circumstancesfor adding cell therapy to the procedure withminimal additional morbidity. In additionto cell-based therapy, non-cellular therapiesincluding growth factor, exosome, and genetherapy may be employed to regeneratebone in ONFH.

【 授权许可】

CC BY-NC