Experimental study on the treatment efficacy of femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells

Abstract

Objective To discuss the treatment efficacy of the femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells. Methods The femoral-head osteonecrosis models on one side were established in forty-two goats using liquid nitrogen, which were randomly classified into three groups after 8 weeks. Group A were conducted umbrella strut bone grafting and bone marrow mesenchymal stem cells transplantation, group B were conducted simple unit side muscle bone flap grafting, and group C were conducted umbrella strut bone grafting and Cancellous bone grafting transplantation. The health side of three groups was treated as self-control. The radiological and histology examination were made at 3,6treated lateral femoral-head shape restored,cystic cnlow-density area disappeared, the original collapse had repaired, and no further collapse of the femoral-head shaped for both group A and B. Bone fusion was good and bone column shadow had been vague for group A, while the bone fusion healed somewhat less and bone column shadow still clear for group B. Group C had irregular contour of femoral head, flat collapse, uneven density, and fracture cracks could be seen at weight-bearing area of femoral head, obviously was the poorest bone had different states: mature and arranged ruled for group A, childish and irregular arrangement for group B, thinning, sparse and fracture for group C. The percentage of empty lacunae counts decreased, while the percentage of trabecular bone area fraction increased for group A. In contrast with group B, and C, the difference was statistically significant (P ＜ 0.05), but the difference was no longer statistically significant when contrast with healthy sides (P ＞ 0.05). 6 months later, the radiological and histology examination showed that:group A and group B had been no significant difference comparing to normal femoral heads, while the femoral head of group C collapsed and disappeared completely. Group A and group B were no difference comparing the healthy side (P ＞ 0.05)in the area fraction of trabecualr bone and percentage of empty lacunae counts, neither it was between group A and group B(P ＞ 0. 05). Conclusion The treatment efficacy of the femoral-head osteonecrosis by umbrella strut bone grafting and bone marrow mesenchymal stem cells was good and was better than cancellous bone grafting transplantation and simple unit side muscle bone flap grafting. Key words: Bone marrow mesenchymal stem cells; Femoral head necrosis; Umbrella strut bone grafting; Biomechanics