Avascular Necrosis (AVN) of the head of the femur is a one of the more challenging causes of hip pain I am asked to treat. I have good news; we have a new treatment option that is less invasive and more likely to result in healing of the bone and elimination of hip joint pain.
The exact cause of AVN has not yet been completely defined. Research has shown that the common finding in patients with hip pain due to AVN is disruption of the blood supply to the bone1. The bone is denied vital oxygen and dies. The dead bone becomes very dense and eventually the joint surface will collapse. Normally the head of the femur is perfectly smooth allowing for free movement of the hip joint. Collapsed or irregular joint surfaces become stiff and painful. With these facts in mind research has been focused on improving the blood supply and stimulating healing/new bone growth with the goal of reversing the causes of AVN.
Stem cells are the units of growth that live in our bone marrow. There has been much talk in the media about stem cells over recent years, but those are fetal stem cells. I am talking about adult stem cells harvested from the patient’s own bone marrow (autologous adult stem cells)2.
Published medical research has now proven that adult stem cells can halt the progression of AVN and eliminate the pain or need for further surgery. In one study 116 patients underwent adult stem cell transplant from their pelvis bone marrow into the femur head to treat Stage I or Stage II AVN3. The researchers found that AVN was reversed in all but 9 cases. That is a 95% success rate in the treatment of AVN! The common theme in all the published research on AVN is the key to success is early detection of the condition before the process has caused irreversible damage and collapse.
We have now moved past the research phase I am glad announce that I can offer Adult Stem Cell therapy for my patients with AVN of the Femur.
Here is how it works
- We need to confirm the diagnosis through physical examination, X-rays of the hip(s) and likely an MRI to define the extend of the process.
- If the diagnosis is confirmed then surgery is scheduled and planned.
- On the day of surgery, in the operating room we collect a portion of bone marrow from the pelvis under general anesthesia.
- The marrow is then processed to concentrate the adult stem cells and remove the cells and materials that are not needed.
- A same tunnel, 6mm in diameter, is then created into the head of the femur through a small incision over the side of the hip, roughly 2cm (less than an inch) in length. By opening the tunnel the surgeon releases the blood pressure inside the femur and allows access into the diseased bone.
- The Adult Stem cells are then injected into the head of the femur through the tunnel, delivering much needed healing material to the diseased portion of the bone.
- The tunnel is then sealed with a bone cement that will prevent the leakage of the Adult Stem Cells out of the bone. The cement is made of the chemical building blocks the body needs to heal bone and it is slowly absorbed and converted into new healthy bone.
Patients treated with this technique can walk immediately without restriction. The incisions heal within days. Most patients treated with this method will feel improvement (reduced pain) within days to weeks. 95% will need no further treatment.
I am pleased to be able to offer this treatment to my patients. Please schedule an appointment to explore the options and see if you or your loved one is a candidate for this novel and exciting new treatment.
To schedule an appointment with Ronald W. Hillock, M.D., Click Here
1 Herndon JH, Aufranc OE. Avascular necrosis of the femoral head in the adult. A review of its incidence in a variety of conditions. Clin Orthop Relat Res. 1972;86:43–62
2 Houdek MT, Wyles CC, Martin JR, Sierra R. Stem cell treatment for Avascular Necrosis of the femoral head: current perspective. Stem Cells and Cloning: Advances and Applications. 2014: 7; 65-70
3 Hernigou P, Beaujean F. Treatment of osteonecrosis with autologous bone marrow grafting. Clin Orthop Relat Res. 2002;405:14–23