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

Le traitement des maladies osseuses par thérapie cellulaire.

Osteonecrosis of the femoral head is a rare disease that affects young patients and is characterized by the occurrence of a necrotic lesion in the femoral head, loss of mechanical resistance of dead bone and collapse of the femoral head. Patients complain of hip pain and loss of function that could lead to total hip replacement. So far, osteonecrosis was considered as a vascular disease due to vascular section or compression leading to bone necrosis. We studied the physiopathology of the osteonecrosis considering it as a bone disease. We demonstrated as well as other teams that the number of mesenchymal stem cells, precursors of bone cells and osteoblastic cells, were reduced in patients with osteonecrosis. We initiated a controlled double blind trial to study the efficacy of stem cells implantation--obtained from concentrated bone marrow--in the osteonecrosis zone. This study showed that bone marrow implantation could delay disease progression to the fractural stage and improve hip pain and joint symptoms. We then tried to improve this treatment by developing a bone cell therapy product formed of osteoblastic cells. A novel cell therapy product formed ofosteoblastic cells, PREOB was developed. PREOB was tested in a randomized, controlled phase II trial in osteonecrosis of the femoral head and showed its superiority compared to concentrated bone marrow. Today, this cellular therapy product is developed by Bone Therapeutics, a spin-offcompany of the "Université libre de Bruxelles". Other bone diseases are characterized by reduced activities of stem cells that are unable to meet the need of bone remodelling due to a non-union fracture, for example. Clinical studies also showed that concentrated bone marrow could be implanted into the non-union. However, its efficacy was dependent on the number of implanted stem cells. The cellular therapy product is currently tested in a phase I trial with promising preliminary results. Cellular therapy for bone diseases is a novel therapeutic approach that evolves from stem cells to the use of the differentiated cells of interest.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Contribution à la physiopathogénie et au traitement de l'ostéonécrose aseptique et non traumatique de la tête fémorale :rôle de l'ostéoblaste et traitement par transplantation de moelle autologue

Doctorat en Sciences médicalesinfo:eu-repo/semantics/nonPublishe

Contribution à la physiopathogénie et au traitement de l'ostéonécrose aseptique et non traumatique de la tête fémorale :rôle de l'ostéoblaste et traitement par transplantation de moelle autologue

Doctorat en Sciences médicalesinfo:eu-repo/semantics/nonPublishe

Analgesic effect of intravenous pamidronate on chronic back pain due to osteoporotic vertebral fractures

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

Perspectives offertes par la thérapie cellulaire ostéoblastique dans l’approche des ostéonécroses maxillaires dues à la prise de biphosphonate

info:eu-repo/semantics/nonPublishe

Actualités dans le traitement de la douleur: Compte-rendu du Congrès Européen "le clinician face à, la douleur chronique", Bruxelles, 2-3/4/2004

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

Treating osteonecrosis with autologous bone marrow cells

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