Dual-source CT-guided Clinical Application Of Targeted Injection Of Mesenchymal Stem Cells In The Treatment Of Early Osteonecrosis Of The Femoral Head

Background and ObjectiveNecrosis of the femoral head (ONFH) is a disease for blood supply of thefemoral head to reduce that caused by a variety of pathogenic factors. The final resultis the hip joint disfunction. For patients with femoral head necrosis, its early course ofthe disease is relatively long, after a period of about3-5years time before thedevelopment of advanced degenerative joint disease of the hip. Making thereasonable intervention, the condition can be reversed.Explored a safe, minimallyinvasive, effective treatment to prevent disease progression and to delay the time ofhip replacement surgery, has been the focus of orthopedic research.Coredecompression surgery for the treatment of early stage osteonecrosis has a long timeand the effect is more ideal.In recent years, with advances in molecular biologytechniques, the bone marrow stem cell technology is widely used, and with thedeepening of osteonecrosis clinical study found that bone marrow stem cells in thetreatment of early osteonecrosis have a significant effect.Choosed an ideal mediatedpathway is the key to the treatment of clinical disease。The most commonly mediatedmethods are by X-ray, MRI,but have certain limitations.In my study for discussionthe clinical results that the dual-source CT-guided core decompression combined with autologous stem cell transplantation in the treatment of early stage (Ⅰ, Ⅱ stage)osteonecrosis.ObjectiveTo investigate the value which dual-source CT-guided core decompressioncombined with bone marrow stem cell transplantation in the treatment ofosteonecrosis of the femoral head.MethodsSelected14patients with osteonecrosis of16hips from orthopedics departmentin the Second Affiliated Hospital of Zhengzhou University from June2010to June2013. By ARCO stage:6hips ofⅠ,10hips of Ⅱ. Using Siemens dual-sourceCT-guided bone marrow core decompression combined with stem cell transplantation.Using SPSS18.0statistical software for preoperative and postoperative Harrisfunction score and imaging results were statistically analyzed.Results14patients, respectively, after6months,12months follow-up.Harris score andimaging results were analyzed.①Harris hip score[2]: from the pre-treatment averagerose to51.3points postoperatively (12months) average84.5points, good rate of86.9%, the difference was statistically significant (P <0.05);②hip imaging[3]:Review of dual-source CT, estimates the total volume of femoral head osteonecrosispercentage share of pre-treatment decreased from an average of29.2to12.1(12months), the difference was statistically significant (P <0.05).Conclusion1.It is a safe and effective method to use core decompression combined withautologous mesenchymal stem cells in the treatment of early osteonecrosis (ⅠandⅡstage). With more precise positioning, shorter operative time, and low costof guiding material.2.It is a new interventional technique of Dual-Source CT guided targeting.