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

Rackwitz, L and Eden, L and Reppenhagen, S and Reichert, JC and Jakob, F and Walles, H and Pullig, O and Tuan, RS and Rudert, M and Nöth, U (2012) Stem cell- and growth factor-based regenerative therapies for avascular necrosis of the femoral head. Stem Cell Research and Therapy, 3 (1).

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Abstract

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 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. © 2012 BioMed Central Ltd.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Rackwitz, L
Eden, L
Reppenhagen, S
Reichert, JC
Jakob, F
Walles, H
Pullig, O
Tuan, RSrst13@pitt.eduRST13
Rudert, M
Nöth, U
Date: 1 March 2012
Date Type: Publication
Journal or Publication Title: Stem Cell Research and Therapy
Volume: 3
Number: 1
DOI or Unique Handle: 10.1186/scrt98
Schools and Programs: School of Medicine > Orthopaedic Surgery
Refereed: Yes
Article Type: Review
Date Deposited: 20 Oct 2016 18:06
Last Modified: 04 Feb 2019 15:59
URI: http://d-scholarship.pitt.edu/id/eprint/29956

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