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P237 - Treatment of early osteonecrosis of femoral head(ONFH) with implantation of autologous cultured osteoblast

Abstract

Purpose

To study functional outcome and radiological progression of cases of ONFHin precollapse stage 2 (ficat –arlet) with the treatment of autologous cultured osteoblast after curettage and core decompression upto mean follow up of 4 years 6 months.

We enrolled 12 patients with stage 1 and stage 2 (ficat arlet) with 6 unilateral avn hip and 6 with bilateral avn hip total 18 hip joints and 12 patients with Idiopathic and steroid induced origin and followed them upto maximum 6 years and minimum 3 years,we did functional outcome with harris hip score also noted the progression on xray and MRI.

Methods and Materials

We enrolled 12 patients with 18 hips ,6 with unilateral AVN and 6 with bilateral AVN

All selected with pre collapse stage upto stage 2 (ficat-arlet) All operated hips had a high possibility of further progression to collapse and arthritis due to presence of large necrotic zone in femoral head on MRI.

These patients treated with implantation of autologous cultured osteoblast after core decompression and curettage.

Pre-op harris hip score was taken and followed upto 3 to 6 years mean follow up 54.6 months

Post op harris hip score was taken. X ray and MRI done pre op and post op.

Results

We followed patient upto 4 years and 6 months mean follow up.

we found harris hip score improved from 33.27 to 72.81 on left hip joint in 12 joints and right side 31.08 to 80.66 In 6 joints out of 12 patients.

Conclusion

For early ONFH of hip joints autologous cultured osteoblast is good treatment to delay hip joint arthritis and preserve hip joint and give good functional outcome to the patient with maximum 6 years follow up.

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