Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jun;35(6):823-9.
doi: 10.1007/s00264-010-1048-y. Epub 2010 May 29.

Concentrated autologous bone marrow aspirate transplantation treatment for corticosteroid-induced osteonecrosis of the femoral head in systemic lupus erythematosus

Tomokazu Yoshioka  1 , Hajime Mishima, Hiroshi Akaogi, Shinsuke Sakai, Meihua Li, Naoyuki Ochiai
Affiliations

Concentrated autologous bone marrow aspirate transplantation treatment for corticosteroid-induced osteonecrosis of the femoral head in systemic lupus erythematosus

Tomokazu Yoshioka et al. Int Orthop. 2011 Jun.

Abstract

The purpose of this study was to evaluate concentrated autologous bone marrow aspirate transplantation (CABMAT) treatment for corticosteroid-induced osteonecrosis of the femoral head (ONFH) in systemic lupus erythematosus (SLE). Bone marrow was aspirated from iliac crests, concentrated on a conventional manual blood bag centrifugation technique that is used to extract buffy coats and then injected into nine hips with drilling. The mean number of nucleated cells for transplantation was 5.32 × 10(7) cells/ml. This cell concentration was significantly higher after concentration, and the mean concentration ratio was 5.5. At follow-up (minimum: three years), significant improvement in pain and Harris Hip Score was observed. For eight of nine hips, we successfully preserved the femoral head. However, one hip required total hip arthroplasty 45 months after the operation. CABMAT using our centrifugation technique is an effective, safe and low-cost procedure of therapeutic osteogenesis for corticosteroid-induced ONFH in SLE.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The number of nucleated cells (×107 cells/ml) in BMA increased significantly after concentration (p < 0.002)
Fig. 2
Fig. 2
VAS: the mean VAS score was significantly reduced after CABMAT (p = 0.02)
Fig. 3
Fig. 3
HHS: the mean HHS score improved significantly after CABMAT (p = 0.01)
Fig. 4
Fig. 4
Representative radiographic images before and after CABMAT. Before CABMAT (upper row), a band pattern was observed on the X-ray (arrows) and changes in the bone marrow signal were observed on MRI scans. Bone marrow oedema (BME) and joint effusion (JE) were evident on an MRI T2-weighted image. The lower row images were obtained during the 3-year follow-up evaluation. Bone consolidation and reduction of the necrotic area were observed on the X-ray and MRI images. Note that bone marrow oedema and joint effusion have disappeared. AP anteroposterior, COR coronal view, T1WI T1-weighted image, T2WI T2-weighted image
Fig. 5
Fig. 5
Radiographic progression after CABMAT in each classification type and stage (n = no. of hips)
See this image and copyright information in PMC

References

    1. Lane NE. Therapy insight: osteoporosis and osteonecrosis in systemic lupus erythematosus. Nat Clin Pract Rheumatol. 2006;2:562–569. doi: 10.1038/ncprheum0298. - DOI - PubMed
    1. Abu-Shakra M, Buskila D, Shoenfeld Y. Osteonecrosis in patients with SLE. Clin Rev Allergy Immunol. 2003;25:13–24. doi: 10.1385/CRIAI:25:1:13. - DOI - PubMed
    1. Fukushima W, Hirota Y, Fujioka M, Kubo T, Tamakoshi A, Nagai M (2007) The final report of the national epidemiologic investigation for idiopathic osteonecrosis of the femoral head. In: Kubo T (ed) Annual report of Japanese investigation committee for intractable diseases, idiopathic osteonecrosis of the femoral head, under the auspices of Ministry of Health and Welfare:1-5 (in Japanese)
    1. Zhao FC, Li ZR, Zhang NF, Wang BL, Sun W, Cheng LM, Liu ZH. Lesion size changes in osteonecrosis of the femoral head: a long-term prospective study using MRI. Int Orthop. 2009 - PMC - PubMed
    1. Egol KA, Jazrawi LM, DeWal H, Su E, Leslie MP, Di Cesare PE. Orthopaedic manifestations of systemic lupus erythematosus. Bull Hosp Jt Dis. 2001;60:29–34. - PubMed

Substances