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Erschienen in:

28.04.2018 | Original Paper

Mid-term results of concentrated autologous bone marrow aspirate transplantation for corticosteroid-associated osteonecrosis of the femoral head in systemic lupus erythematosus

verfasst von: Yohei Tomaru, Tomokazu Yoshioka, Hisashi Sugaya, Yukiyo Shimizu, Katsuya Aoto, Hiroshi Wada, Hiroshi Akaogi, Masashi Yamazaki, Hajime Mishima

Erschienen in: International Orthopaedics | Ausgabe 7/2018

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Abstract

Purpose

We had previously established concentrated autologous bone marrow aspirate transplantation (CABMAT), a one-step, low-invasive, joint-preserving surgical technique for treating osteonecrosis of the femoral head (ONFH). This study aimed to evaluate the effects of CABMAT as a hip-preserving surgical approach, preventing conversion to total hip arthroplasty (THA) and femoral head collapse in patients with systemic lupus erythematosus (SLE).

Methods

Since 2003, 52 SLE patients (8 male, 44 female, 92 hips, mean age 35.3 (16–77) (years) were treated with CABMAT. The mean follow-up period was 5.5 (0.7–14) years. Conversion rate to THA and its predicting factors were analyzed.

Results

The overall conversion rate to THA was 29% (27/92). Conversion rate to THA was 0% (0/3), 0% (0/4), 22% (9/41), and 41% (18/44) in types A, B, C1, and C2, respectively. Conversion rate to THA was 26% (5/19), 26% (6/23), 28% (11/39), 44% (4/9), and 50% (1/2) in stages 1, 2, 3A, 3B, and 4, respectively. In multivariate logistic regression analysis, sex, body mass index (BMI), pre-operative type, and pre-operative stage were significantly correlated with conversion to THA.

Conclusion

The conversion rate to THA was lower than that in the natural course and core decompression, but was higher than that seen in other bone marrow transplantation and osteotomy. Since sex, pre-operative type, and pre-operative stage were significantly correlated with conversion to THA, it is suggested that the higher proportion of women, advanced stage (stage 3A or above), and advanced type (type C or above) in this study affected the THA conversion rate.

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Titel: Mid-term results of concentrated autologous bone marrow aspirate transplantation for corticosteroid-associated osteonecrosis of the femoral head in systemic lupus erythematosus
verfasst von: Yohei Tomaru
Tomokazu Yoshioka
Hisashi Sugaya
Yukiyo Shimizu
Katsuya Aoto
Hiroshi Wada
Hiroshi Akaogi
Masashi Yamazaki
Hajime Mishima
Publikationsdatum: 28.04.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 7/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3959-y

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Mid-term results of concentrated autologous bone marrow aspirate transplantation for corticosteroid-associated osteonecrosis of the femoral head in systemic lupus erythematosus