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Stem cell- and growth factor-based regenerative therapies for avascular necrosis of the femoral head

Please always quote using this URN: urn:nbn:de:bvb:20-opus-135413
  • Avascular necrosis (AVN) of the femoral head is a debilitating disease of multifactorial genesis, predominately affects young patients, and often leads to the development of secondary osteoarthritis. The evolving field of regenerative medicine offers promising treatment strategies using cells, biomaterial scaffolds, and bioactive factors, which might improve clinical outcome. Early stages of AVN with preserved structural integrity of the subchondral plate are accessible to retrograde surgical procedures, such as core decompression to reduce theAvascular necrosis (AVN) of the femoral head is a debilitating disease of multifactorial genesis, predominately affects young patients, and often leads to the development of secondary osteoarthritis. The evolving field of regenerative medicine offers promising treatment strategies using cells, biomaterial scaffolds, and bioactive factors, which might improve clinical outcome. Early stages of AVN with preserved structural integrity of the subchondral plate are accessible to retrograde surgical procedures, such as core decompression to reduce the intraosseous pressure and to induce bone remodeling. The additive application of concentrated bone marrow aspirates, ex vivo expanded mesenchymal stem cells, and osteogenic or angiogenic growth factors (or both) holds great potential to improve bone regeneration. In contrast, advanced stages of AVN with collapsed subchondral bone require an osteochondral reconstruction to preserve the physiological joint function. Analogously to strategies for osteochondral reconstruction in the knee, anterograde surgical techniques, such as osteochondral transplantation (mosaicplasty), matrix-based autologous chondrocyte implantation, or the use of acellular scaffolds alone, might preserve joint function and reduce the need for hip replacement. This review summarizes recent experimental accomplishments and initial clinical findings in the field of regenerative medicine which apply cells, growth factors, and matrices to address the clinical problem of AVN.show moreshow less

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Metadaten
Author: Lars Rackwitz, Lars Eden, Stephan Reppenhagen, Johannes C. Reichert, Franz Jakob, Heike Walles, Oliver Pullig, Rocky S. Tuan, Maximilian Rudert, Ulrich Nöth
URN:urn:nbn:de:bvb:20-opus-135413
Document Type:Journal article
Faculties:Medizinische Fakultät / Lehrstuhl für Orthopädie
Medizinische Fakultät / Lehrstuhl für Tissue Engineering und Regenerative Medizin
Language:English
Parent Title (English):Stem Cell Research & Therapy
Year of Completion:2012
Volume:3
Issue:7
Source:Stem Cell Research & Therapy 2012, 3:7. doi:10.1186/scrt98
DOI:https://doi.org/10.1186/scrt98
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 612 Humanphysiologie
Tag:autologous chondrocyte implantation; colony-stimulating factor; core depression; mesenchymal cells; osteochondral allografts; osteogenesis imperfecta; progenitor cells; segmental collapse; sheep model; stromal cells
Release Date:2018/04/03
EU-Project number / Contract (GA) number:242175
OpenAIRE:OpenAIRE
Licence (German):License LogoDeutsches Urheberrecht