Avascular Necrosis Treatment Case Study

Dr. Centeno’s Analysis:

KP is a computer specialist who was diagnosed with avascular necrosis of the hip. This disease is progressive, so KP was alarmed when each successive MRI showed these areas of dead bone getting bigger and bigger. He was told that radical surgery was his only option.

Outcome:

The patient’s stem cells were grown in culture and then transplanted back into the hip with the most severe AVN using a needle. KP had minimal downtime after his procedure and was able to walk with crutches out of the office and returned back to his usual activities right away. He continued crutch use for six weeks but said he was able to walk around ok after the first couple of weeks.

Images/Data:

In order to determine if the size of KP’s lesions had stabilized or gotten better, we performed a computerized volume analysis of his AVN lesions. The data (now submitted for research publication as a clinical case study) is below. Of note, his right sided AVN lesions reduced in size by 24 percent. The interesting thing is that the opposite side (not treated) also reduced in size by a lesser degree (16 percent). This is consistent with other studies using mesenchymal stem cells to treat damaged areas (such as heart). In these studies, cells placed in the area of damage effect the most repair in that area, but lesser degrees of repair can still be obtained by injecting the cells in a distant vein. Since the marrow space where the cells were placed on the right is very vascular, we believe most of the cells stayed where we placed them, but some hitched a ride and “homed” to the left hip. These findings have implications for other AVN patients, as in some patients with problems in multiple areas, it may be possible to treat only one site.

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