Article révisé par les pairs
Résumé : Aseptic non traumatic osteonecrosis of the femoral head is a painful disorder of the hip that can lead to femoral head collapse, osteoarthritis and the need of total hip replacement. Since osteonecrosis may be a disease of mesenchymal or bone cells, the possibility has been raised that bone marrow containing osteogenic precursors could be implanted into the necrotic region. Therefore we studied in a prospective and controlled trial the efficacy of bone marrow implantation on symptoms and progression of the osteonecrosis. We studied 13 patients with stage 1or 2 osteonecrosis. The hips were allocated to either core decompression or bone marrow grafting. After 24 months, there was a significant reduction of pain and in joints symptoms. At 24 months, 5 of the 8 hips had deteriorated to the stage 3 in the control group whereas only one had deteriorated to this later stage in the bone marrow grafted group. Implantation of bone marrow appears to be an effective treatment for early stages of osteonecrosis.