Original Full Length Article Autologous bone marrow cell implantation in the treatment of non-traumatic osteonecrosis of the femoral head: Five year follow-up of a prospective controlled study

Objective: To determine the efficacy of bone marrow cell implantation into the necrotic lesion of the femoral head on clinical symptoms and the progression of osteonecrosis of the femoral head in comparison with core decompression. Methods: We studied nineteen patients and twenty four hips with early stage osteonecrosis of the femoral head. The hips were allocated to either core decompression only or core decompression and implantation of bone marrow cells. Both patients and assessors were blind with respect to treatment group assignment. The primary outcomes were clinical symptoms and disease progression. Results: Bone marrow implantation afforded a significant reduction in pain and in joint symptoms and reduced the incidence of fractural stages. At 60 months, eight of the eleven hips in the control group had deteriorated to the fractural stage whereas only three of the thirteen hips in the bone marrow graft group had progressed to that stage. Survival analysis showed a significant difference in the time to failure between the two groups at 60 months. Patients had only minor side-effects after the treatments. Conclusions: This long term follow-up study confirmed that implantation of autologous bone marrow cells in the necrotic lesion might be an effective treatment for patients with early stages of osteonecrosis of the femoral head

Update in non-union treatment

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What future for mesenchymal stem cells in musculoskeletal diseases?

Regenerative medicine using mesenchymal stem cells (MSC) is developped in several musculoskeletal diseases. The concentration of bone marrow or adipose tissue has been the most common therapeutic method used. The large variability of the cell-productions, however, could be a limitation. Recent biological research concerning MSC has unearthed several new aspects. Firstly, a heterogeneity of the MSC was found following the tissue origin and/or the patient's. Then, the characterisation of MSC was improved by using new combinations of cellular membrane markers. Another important step was the discovery of the paracrine activity of MSC. The MSCs are able to produce a lot of growth factors and cytokines, a production of extra cellular vesicles like exosomes arising an intercellular signaling. MSCs were found to have not only a proliferation and differentiation performance to restore the damages of time, but also immunomodulation and anti-inflammation activities. The field of cell-based therapy with MSC is enlarged with newer and more promising methods than bone marrow concentrate. Expansion culture methods of MSC have been developped, as in vitro differentiation in osteoblasts and chondrocytes or cell manipulations by transfection to produce induced pluripotent stem cells or super MSCs able to produce more growth factors or cytokines, or to modify the membrane signaling for improving MSC homing. The translation of these biological developments in human therapy is the key for the MSC future. After pre-clinical tests to verify the safety, controlled trials are needed to define the true place of this regenerative medicine. © 2020 Société Française de Rhumatologi

non omeract expert rheumatologists sonographers and interultrasound machine reliability of the omeract ultrasound scoring in rheumatoid arthritis in a clinical-based setting: a belgian study

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Double-blind, placebo-controlled study of OM-8980 in rheumatoid arthritis

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Resultados obtenidos a largo plazo en el tratamiento de la necrosis avascular en cabeza femoral con los campos electromagneticos pulsatiles (PEMF's)

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Long term results in electromagnetic fields (EMF) treatment of osteonecrosis

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