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自体基质血管成分(SVF)(萨哈杰疗法)直接超声处理用于股骨头坏死(ONFH)的功能结果分析:一项6年随访研究

Functional Outcome Analysis of Autologous Stromal Vascular Fraction (SVF) (Sahaj Therapy) Using Direct Sonication in Osteonecrosis of the Femoral Head (ONFH): A 6-Year Follow-Up Study.

作者信息

Tantuway Vinay, Jeyaraman Madhan, Nallakumarasamy Arulkumar, Prikh Mittal B, Sharma Aashish K, Sharma Raj

机构信息

Department of Orthopaedics and Traumatology, Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh India.

Sahaj Regenerative Cell Therapeutics, Indore, Madhya Pradesh India.

出版信息

Indian J Orthop. 2023 Nov 21;58(1):68-78. doi: 10.1007/s43465-023-01041-y. eCollection 2024 Jan.

Abstract

INTRODUCTION

We investigated the safety, efficacy, functional, and clinical outcomes of intra-osseous implantation of mechanically isolated, autologous stromal vascular fraction (SVF), an Australian patented direct ultrasonication technology (Sahaj Therapy) in osteonecrosis of the femoral head (ONFH).

MATERIALS AND METHODS

A total of 32 cases of ONFH were enrolled in the study after confirming with an MRI of the affected hip. All cases were treated with an intra-osseous autologous SVF implantation [4-5 cc with the cellular dosage of 8.0 × 10 cells with a viability of > 85% SVF cells] on the same surgical sitting. All the cases were followed up clinically, functionally, and radiologically at regular intervals. A comparison of mean HOOS scores at different follow-ups was done using Paired ''-test. A value of < 0.05 was considered significant.

RESULTS

In our study, male preponderance was seen (53.1%). According to the modified Ficat and Arlet classification, the most common grade of ONFH was grade 2 [right: 25 hips and left: 25 hips]. There was a statistically significant improvement in the mean HOOS score of the right hip ( = 10) and left hip ( = 9) from preoperative time till 72 months ( < 0.05). The follow-up MRI of the affected hips shows improved osteogenesis without any further worsening of the contour of the femoral head. No adverse effects were seen in any of the study participants.

CONCLUSION

For individuals with ONFH, treated with intra-osseous autologous SVF implantation in the same surgical procedure is an innovative and promising treatment modality. Even after 6 years of follow-up, the study participants with ONFH have shown good clinical and functional outcomes with autologous SVF.

摘要

引言

我们研究了采用澳大利亚专利的直接超声技术(Sahaj疗法)将机械分离的自体基质血管成分(SVF)进行骨内植入治疗股骨头坏死(ONFH)的安全性、有效性、功能及临床结果。

材料与方法

经患侧髋关节MRI确诊后,共有32例ONFH患者纳入本研究。所有病例均在同一手术中接受骨内自体SVF植入治疗[4 - 5毫升,细胞剂量为8.0×10个细胞,SVF细胞活力>85%]。所有病例均定期进行临床、功能及影像学随访。使用配对t检验对不同随访时间的平均髋关节功能评分(HOOS)进行比较。P值<0.05被认为具有统计学意义。

结果

在我们的研究中,男性占优势(53.1%)。根据改良的Ficat和Arlet分类,ONFH最常见的分级为2级[右侧:25髋,左侧:25髋]。从术前到72个月,右侧髋关节(P = 10)和左侧髋关节(P = 9)的平均HOOS评分有统计学意义的改善(P<0.05)。患侧髋关节的随访MRI显示骨生成改善,股骨头轮廓未进一步恶化。所有研究参与者均未出现不良反应。

结论

对于ONFH患者,在同一手术中进行骨内自体SVF植入治疗是一种创新且有前景的治疗方式。即使经过6年的随访,ONFH研究参与者接受自体SVF治疗仍显示出良好的临床和功能结果。

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