Volume 4, 2018
|Number of page(s)||5|
|Published online||05 November 2018|
Unusual indication of Cell therapy for hip osteonecrosis after pregnancy
Hôpital Henri Mondor,
51 avenue du Maréchal de Tassigny, 94000
2 Auregan Jean Charles, Hopital Antoine Beclere, 157 Rue de la Porte de Trivaux, 92140 Clamart, France
* Corresponding author: firstname.lastname@example.org
Accepted: 5 September 2018
Purpose: Osteonecrosis is a rare event during or after pregnancy. Due to the low number of cases, there is no report of long-term results after conservative surgery in this population.
Method: From 1992 to 2010, 145 consecutive female patients with unilateral symptomatic (94 stage I and 51 stage II) left hip osteonecrosis (ON) related to pregnancy were treated between 4 and 16 months after delivery with percutaneous mesenchymal stem cell (MSC) injection obtained from bone marrow concentration. The average total number of MSCs (counted as number of colonies forming units-fibroblast) injected in the hip was 185 000 ± 65 000 cells (range 95 000–240 000 cells).
Results: At the most recent follow-up (average 15 years after hip surgery, range 8–25 years), among the 145 hips included in the study, 4 hips (2.7%) had collapsed and were treated with total hip arthroplasty (THA). Thirty-two of the 94 stage I had progressed to stage II; and 4 of the 51 stage II had progressed to stage III and collapse. The other 141 hips (97.3%) were without collapse and pain free. On MRI, as percentage of the volume of the femoral head, the osteonecrosis had decreased from 34.5% pre-operatively to 6% at the most recent follow-up. For women who had other children after treatment, a subsequent pregnancy was not associated with osteonecrosis.
Conclusion: Patients with hip osteonecrosis following pregnancy had a low conversion rate to THA when treated early with cell therapy.
Key words: Cell therapy / Mesenchymal stem cell / Hip osteonecrosis / Pregnancy
© The Authors, published by EDP Sciences, 2018
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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