Efficacy of autologous stem cell-based therapy for XXXX of the femoral head in @entity3458 : a five-year follow-up study.

@entity1 @entity7 @entity3458 @entity158 @entity687 @entity2530
INTRODUCTION: Stem cell therapy with bone marrow-derived mononuclear cells (BMMCs) is an option for improving joint function in @entity2530 of the femoral head (ONFH). Bone marrow-derived mesenchymal stromal cell (MSC) numbers and their osteogenic differentiation are decreased in @entity1 with ONFH. However, whether this decrease also extends to the early stages of ONFH in @entity3458 ( @entity3458 ) is still unclear. METHODS: We conducted a phase I/II, non-controlled study to determine efficacy and safety of BMMC implantation using a minimally invasive technique in @entity3458 @entity1 with ONFH. Eighty-nine @entity1 were recruited and followed up for 60 months after surgery. Clinical and radiographic findings were assessed, and data were completed by in vitro analysis. RESULTS: At the final follow-up (60 months) there was a significant improvement in clinical joint symptoms and @entity158 relief as measured by the Harris Hip Score (P = 0.0005). In addition, after the BMMC implantation procedure, radiographic assessment showed disease stabilization and only 3.7 % of the treated @entity1 did not achieve a satisfactory clinical result. The amount of fibroblast colony-forming units was 28.2    13.9 per 1 million BMMCs after concentration. Flow cytometry analysis showed a significantly higher number of hematopoietic stem/endothelial progenitor cell markers in concentrated BMMCs when compared with bone marrow aspirate, indicating an enrichment of these cell types. Isolated MSCs from @entity3458 @entity1 with pre-collapse ONFH maintained the replicative capacity without significant loss of their specific biomolecular characteristics, multi-differentiation potential, and osteogenic differentiation activities. Cytokines and growth factors ( @entity687 , transforming growth factor-beta, stromal cell-derived factor-1alpha and @entity7 ) that mediate endogenous bone regeneration were also produced by expanded MSCs from @entity3458 @entity1 . CONCLUSION: The autologous BMMC implantation with a minimally invasive technique resulted in significant @entity158 relief and halted the progression of early stages of ONFH in @entity3458 @entity1 . MSCs from @entity3458 @entity1 display biological properties that may add to the efficiency of surgical treatment in ONFH. In summary, our results indicate that infusion of BMMCs enriched with stem/progenitor cells is a safe and effective treatment for the early stages of ONFH in @entity3458 @entity1 . TRIAL REGISTRATION: ClinicalTrials.gov NCT02448121 ; registered 15 May 2015.
