Etiopathogenesis and Stem Cell Treatment Outcomes in Avascular Necrosis of the Femoral Head: A Review of 50 Cases

Abstract

Background and Aim: Avascular necrosis (AVN) is a progressive condition characterized by a vascular insult to the bone, which can lead to collapse of the bone and subsequent degenerative changes. Vascular impairment that results in AVN may occur due to compression of blood vessels that may be due to trauma, immunosuppressive medications or idiopathic etiology. The aim of this review was to identify the prevalence of AVN based on age, sex and causative factors. This review also aimed to analyze the outcome of autologous mesenchymal stem cell therapy in patients suffering from avascular necrosis of femoral head. Methods: 50 cases of avascular necrosis who had undergone autologous mesenchymal stem cell therapy were included in the study. Demographic and etiologic categorization was done based on data obtained from case history of patients. Outcome following cell based therapy was done based on Harris Hip Score and radiographic tests (X-ray, MRI). Results and Conclusion: Based on findings in this review, prolonged steroid medication was found to be the prime causative factor for non-traumatic AVN of femoral head.  Autologous cell based therapy has been shown to be effective in arresting progression of the condition. Analysis showed statistically significant outcomes with respect to parameters of pain, joint function and range of motion following cell based therapy. This minimally invasive procedure is effective in management of all stages of the condition and aids in preservation/regeneration of joint structure.