Treatment of AVN using the induction chamber technique and a biological-based approach: indications and clinical results

Abstract

Objective: To determine the efficacy of core decompression (CD) technique combined with recombinant morphogenetic proteins, autologous mesenchymal stem cells (MSCs) and xenograft bone substitute into the necrotic lesion of the femoral head on clinical symptoms and on the progression of osteonecrosis of the femoral head.

Patients and methods: A total of 38 patients (40 hips) with early stage osteonecrosis of the femoral head were studied over a 4-year period.

Results: CD technique combined with recombinant morphogenetic proteins, autologous MSCs and xenograft bone substitute was associated with a significant reduction in both pain and joint symptoms and reduced the incidence of fractural stages. At 36 months, 33 patients achieved clinical and radiographic healing.

Conclusion: This long-term follow-up study confirmed that CD technique combined with recombinant morphogenetic proteins, autologous MSCs and xenograft bone substitute may be an effective treatment for patients with early stage osteonecrosis of the femoral head.

Keywords: AVN; Autologous implantation; Avascular necrosis; Biological chamber; Core decompression; Early stage; Femoral head; Mesenchymal stem cells; Osteonecrosis; rhBMP.