Treatment of Osteonecrosis of the Femoral Head with Implantation of Autologous Bone-Marrow Cells by Valérie Gangji, and Jean-Philippe Hauzeur JBJS Essent.

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Presentation transcript:

Treatment of Osteonecrosis of the Femoral Head with Implantation of Autologous Bone-Marrow Cells by Valérie Gangji, and Jean-Philippe Hauzeur JBJS Essent Surg Tech Volume os-87(1 suppl 1): March 1, 2005 ©2005 by The Journal of Bone and Joint Surgery, Inc.

The needles for the bone-marrow aspiration are introduced deep into both iliac crests, and the bone marrow is aspirated with 10-mL syringes. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

After the bone-marrow aspiration, the contents of each syringe are transferred into the bone- marrow-collection kit. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

A c-arm fluoroscope is positioned over the hip region like an arch. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

A 5-mm incision is made laterally through the skin and the fascia at the level of, or just distal to, the greater trochanter. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

The trephine (with an outer diameter of 5 mm and an inner diameter of 3 mm) used for the core decompression. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

The direction of the trephine must be adjusted in both the anteroposterior and the lateral plane so that it is pointing toward the osteone-crotic zone. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

The tip of the trephine is placed at a distance of 2 to 3 mm from the articular cartilage. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.

The 50 mL of mononuclear cells is injected through the trephine that was placed into the necrotic lesion. Valérie Gangji, and Jean-Philippe Hauzeur J Bone Joint Surg Am 2005;os-87: ©2005 by The Journal of Bone and Joint Surgery, Inc.