Philippe Hernigou*, Yasuhiro Homma, Arnaud Dubory, Jacques Pariat, Damien Potage, Charles Henri Flouzat Lachaniette, Nathalie Chevallier and Helene Rouard
When Total Hip Arthroplasty (THA) is required in a patient with developmental dysplasia of the hip (DDH), bone deficiency in the acetabular roof often remains a problem. The iliac crest (IC) has long been the preferred source of autograft material, but graft harvest is associated with frequent complications and pain. Autologous bone graft can also be obtained from the femoral head (FH) for reconstruction of the acetabulum in hip arthroplasty. However, in certain challenging clinical scenarios, incorporation of the femoral head autograft appears less successful than the iliac crest autograft. The difference in potential for proliferation and osteoblastic differentiation between the two sites has still not been evaluated; therefore, it is not known how to compensate for this difference when it is present. We designed this study to evaluate the number of mesenchymal stem cells (MSCs) in both the iliac crest and femoral head of the same patient. We also determined the best operating room procedure for loading the femoral head with MSCs to achieve equivalent numbers of MSCs as in the IC. Twenty patients (8 men and 16 women) undergoing THA for DDH were enrolled in the study. The mean age was 55.5 years (range 41–65 years). Bone marrow aspirates were obtained from three depths within the femoral head and the aspirates were quantified relative to matched iliac crest aspirates that were obtained from the same patient at the same time. The cell count, progenitor cell concentration (cells/mL marrow), and progenitor cell prevalence (progenitor cells/million nucleated cells) were calculated.
Aspirates of FH marrow demonstrated less concentrations of mononuclear cells compared with matched controls from the iliac crest. Progenitor cell concentrations were consistently lower in FH aspirates compared to matched controls from the iliac crest (p = 0.05). The concentration of osteogenic progenitor cells was, on average, 40% lower in the FH aspirates than in the paired iliac crest samples (p = 0.05). However, with bone marrow aspirated from the iliac crest, we were able to load the femoral head autograft with sufficient MSCs to obtain the same number as present in an iliac crest. With concentrated bone marrow from the IC, supercharging the femoral autograft with MSCs to numbers above that present in the IC was possible in the operating room, and the number of MSCs supercharged in the femoral head was predictable.
Based on these findings we suggest that FH graft supercharged with BM-MSCs from the IC is comparable to IC graft for osseous graft supplementation especially in THA for patients with DDH.
Tess Szekelyi, Xavier Lannes, Mouas Jammal, Salah Dine Qanadli and Michael Wettstein*
Published on: 1st March, 2024
Periacetabular Osteotomy (PAO) is the gold standard for the treatment of hip dysplasia or acetabular retroversion. Due to the proximity of intra-pelvic arteries, there is a risk of iatrogenic vascular injuries, which can present with a delay and should be part of the differential diagnosis of significant pain following a PAO. We present the case of a never-described vascular injury following a periacetabular osteotomy in a 25-year-old woman who presented with gluteal pain 3 weeks after surgery. A delayed diagnosis of a pseudoaneurysm of the superior gluteal artery was made and successfully treated by embolization. The lesion is most probably related to the tip of a screw or to the drilling process.
I very much appreciate the humanitarian services provided in my stead by this journal/publisher.
It exhibits total absence of editorial impertinence. As an Author, I have been guided to have a fruitf...
Chrysanthus Chukwuma
''Co-operation of Archives of Surgery and Clinical Research journal is appreciable. I'm impressed at the promptness of the publishing staff and the professionalism displayed. Thank you very much for y...
Anıl Gokce
We really appreciate and thanks the full waiver you provide for our article. We happy to publish our paper in your journal. Thank you very much for your good support and services.
Ali Abusafia
The service is nice and the time of processing the application is fast.
Department of Neurosurgery, Queen Elizabeth Hospit...
Long Ching
"An amazing experience with the Journal of Advanced Pediatrics and Child Health. Very fast blind review with pertinent corrections and suggestions. I highly recommand both the journal and the editor."
Chaimae Khairoun
Thank you very much for accepting our manuscript in your journal “International Journal of Clinical Virology”. We are very thankful to the esteemed team for timely response and quick review proces...
Abdul Baset
I want to thank you for our collaboration. You were fast and effective with a positive spirit of teamwork.
I am truly excited from our collaboration. You were like always fast, efficient and accurate...
Aikaterini Solomou
"It was a pleasure to work with the editorial team of the journal on the submission of the manuscript. The team was professional, fast, and to the point".
NC A&T State University, USA
Moran Sciamama-Saghiv
Submission of paper was smooth, the review process was fast. I had excellent communication and on time response from the editor.
Ekiti State University Teaching Hospital, Nigeria
Ayokunle Dada
"This is my first time publishing with the journal/publisher. I am impressed at the promptness of the publishing staff and the professionalism displayed. Thank you for encouraging young researchers li...
HSPI: We're glad you're here. Please click "create a new Query" if you are a new visitor to our website and need further information from us.
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."