Stem cell- and growth factor-based regenerative therapies for avascular necrosis of the femoral head
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- 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.…
Autor(en): | Lars Rackwitz, Lars Eden, Stephan Reppenhagen, Johannes C. Reichert, Franz Jakob, Heike Walles, Oliver Pullig, Rocky S. Tuan, Maximilian Rudert, Ulrich Nöth |
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URN: | urn:nbn:de:bvb:20-opus-135413 |
Dokumentart: | Artikel / Aufsatz in einer Zeitschrift |
Institute der Universität: | Medizinische Fakultät / Lehrstuhl für Orthopädie |
Medizinische Fakultät / Lehrstuhl für Tissue Engineering und Regenerative Medizin | |
Sprache der Veröffentlichung: | Englisch |
Titel des übergeordneten Werkes / der Zeitschrift (Englisch): | Stem Cell Research & Therapy |
Erscheinungsjahr: | 2012 |
Band / Jahrgang: | 3 |
Heft / Ausgabe: | 7 |
Originalveröffentlichung / Quelle: | Stem Cell Research & Therapy 2012, 3:7. doi:10.1186/scrt98 |
DOI: | https://doi.org/10.1186/scrt98 |
Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 612 Humanphysiologie |
Freie Schlagwort(e): | autologous chondrocyte implantation; colony-stimulating factor; core depression; mesenchymal cells; osteochondral allografts; osteogenesis imperfecta; progenitor cells; segmental collapse; sheep model; stromal cells |
Datum der Freischaltung: | 03.04.2018 |
EU-Projektnummer / Contract (GA) number: | 242175 |
OpenAIRE: | OpenAIRE |
Lizenz (Deutsch): | Deutsches Urheberrecht |