Autologous grafts in the treatment of avascular osteonecrosis of the femoral head.

• DOI: 10.23750/abm.v91i2.8188
• Publication Date: 2020-05-11
• Authors: Marco Marcarelli; Marco Fiammengo; Letizia Trovato; Vincenzo Lancione; Elvio Novarese; Pier Francesco In...; Salvatore Risitano
• Keywords: Avascular Necrosis; Harris Hip Score; Cancellous bone

BACKGROUND Osteonecrosis of the femoral head (ONFH) is a frequent orthopedic disease leading to destruction hip joint and disabling arthritis. Several procedures have been developed treat deterioration in case osteonecrosis, trying avoid or delay an intervention total replacement, especially young patients. The aim this study was analyze use autologous bone micrografts derived from cancellous management avascular ONFH. treatment described implemented using Rigenera® protocol obtain micrografts: small fragments collected by neck, disaggregated injected necrotic area empty screw. MATERIALS AND METHODS Twenty adult patients affected ONFH were enrolled study; all reported preoperative intermittent coxo-arthrosis limited function intra extra rotation hip. Inclusion criteria were an Oxford Hip Score between (OHS) 20 39, Harris score (HHS) showing pre-operative poor results (lower than 70 points) stage II-IIIA IIIB according with classification proposed Association Research Circulation Osseous (ARCO). RESULTS Using MRI evaluation, after six months, authors observed complete regression restoration osseous structure. Clinical outcome has evaluated at 6-12 24 months follow-up. At final F.U. HHS rised good (mean value F.U 84) while OHS improved significantly already 21 days injection 35.4 ± 7.5) increasing trend until two-year FU 37.4 9.5). full recovery daily mild sport activities reached 90 intervention, respectively. CONCLUSION are suggestive for new approach assuming process regeneration based on dual mechanism action, biological mechanical, induced screw as vehicle.