Can an injection of stem cells act as a hip AVN surgery alternative? PL is a young man in his twenties who was diagnosed with hip AVN. Like many diagnosed with this disease, he had no risk factors and it’s likely that we’ll never know how he got the disease. He saw several orthopedic surgeons who suggested everything from a CORE decompression surgery to a hip replacement surgery, but he ultimately decided for an injection of his own stem cells. His MRIs now show about 90% resolution of his disease over the past few months.
Hip avascular necrosis (AVN or osteonecrosis) is a serious disease that can turn your hip bone to mush in a matter of months. We can use yesterday’s blog on how bone works to explain what happens in AVN. Basically, the normal stem cells in the hip that help to replace the worn out osteoblast cells that make new bone and repair damaged bone develop a problem. So as the bone making cells die off and aren’t replaced, the normal wear and tear on the bone accumulates. With a less than optimal repair system, the bone damage eventually reaches a critical mass and the bone begins to collapse. One way to treat the problem is to do something that stimulates growth, like bore a tunnel in the hip bone. The other is to surgically amputate the hip and put in a hip replacement device. Another method that’s been used since the 90s in Europe is to use a thin trocar type needle to inject the patient’s own stem cells into the diseased bone, using precise imaging guidance.
PLs MRIs are above. You can see his left hip bone is bright on the before T2 weighted MRI (right) and dark on the PD weighted MRI (left.) This indicates AVN and if left this way for any significant amount of time, the hip femur bone will begin to collapse, resulting in a square peg in a round hole. The after MRI is also above, where the bight bone becomes normally dark and vice versa. There’s still one spot left to treat in the area just under the bone (subcortical). These MRI changes are just a few months after his own stem cells were injected. This is what he has to say:
“There is no comparison to before and after. I don’t have sharp shooting pain or pain when I walk like I did before the procedure. It’s really night and day difference.”
The upshot? An highly precise injection of our own stem cells beats the heck out of a hip replacement. PL will likely need a second treatment on the remaining spot, but with his MRI image changes, we’re encouraged that he’ll continue to do well!