Objective: To investigate the efficacy and safety of drilling and injection of concentrated bone barrow in the treatment of Osteonecrosis of the Femoral Head (ONFH).
Patients and Methods: 12 patients (20 hips) with ONFH were recruited in this study. All these patients were treated with drilling and injection of concentrated bone marrow. The concentrated autologous bone marrow was harvested from posterior iliac crest and then injected into the femoral head after drilling. ARCO (Associated Research Circulation Osseous) stage was used to classify the stage of ONFH. Harris hip score was used to evaluate the clinical symptoms of osteonecrosis. Modified Kerboul angle was used to assess radiological development of osteonecrosis.
ARCO stage, Harris Hip Score and Modified Kerboul angle were assessed at the onset of treatment and at 6, 12, 24 months after the initial treatment.
Results: A follow-up on the patient was done at the end of two years (mean 1.8 years ranging from 1.5 to 2 years). Despite short term follow up, clinical and radiological improvement on X-rays and MRI was detected, eleven out of twelve patients reported improvement from symptoms. There was a significant postoperative increase in the HHS (92.3 ± 3.1 points) compared to preoperative HHS (68.5 ± 9.7 points). There was a significant postoperative decrease in modified Kerboul angle (140 ±41.3) compared to preoperative (219 ±27). All patients stated that they are satisfied about the results and that they had better quality of life post-operatively. No complications were found in any patients.
Conclusions: Drilling and Injection of Concentrated Bone Marrow can relieve symptoms, improve hip function and delay the progression of ONFH. The clinical outcome is better when it is applied prior to collapse of the femoral head. This work demonstrates that this method is a safe, effective and minimally invasive treatment strategy for early-stage ONFH.