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AVN & Stem Cell Surgeon

AVN & Stem Cell Surgeon

Avascular necrosis (AVN) of the femoral head is a progressive disease that predominantly affects younger patients. Although the exact pathophysiology of AVN has yet to be elucidated, the disease is characterized by a vascular insult to the blood supply of the femoral head, which can lead to collapse of the femoral head and subsequent degenerative changes. If AVN is diagnosed in the early stages of the disease, it may be possible to attempt surgical procedures which preserve the hip joint, including decompression of the femoral head augmented with concentrated bone marrow. The use of autologous stem cells has shown promise in halting the progression of AVN of the femoral head, and subsequently preventing young patients from undergoing total hip arthroplasty. The purpose of this study was to review the current use of stem cells for the treatment of AVN of the femoral head.

Although the pathophysiology of AVN is not yet well-understood, it is thought to be a multifactorial disease, with patients reporting a history of exposure to one or more risk factors, including trauma to the hip, alcohol abuse, corticosteroid use, hemoglobinopathies, pregnancy, coagulopathies, organ transplant, chemotherapy, caisson disease, HIV and autoimmune conditions.

Some assert that the disease results from a clotting disorder or genetic abnormality that leads to vascular compromise, while others hypothesize that increased intramedullary pressure in the femoral head leads to decreased blood flow and cell death via a mechanism similar to compartment syndrome following a traumatic injury.

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