Simple Hip Decompression

Stem Cells Get Hip

Mayo Clinic orthopedic surgeon Dr. Raphael Sierra is glad he can help this patient walk again by replacing her badly damaged hip joint, but he'd rather help patients avoid such surgery entirely. She's only 19 years old. Harsh rounds of chemotherapy helped her beat cancer, but caused a condition called osteonecrosis.

Essentially, the death of the bone.

It can happen to knee, ankle or shoulder joints, but most commonly occurs in the hip, at the top of the femur, or thigh bone. 80 – 95% of patients eventually need artificial joint replacement. However, injections of stem cells have healed the hips of some of Dr. Sierra's patients, with a minimally invasive, 45-minute outpatient procedure that poses very little risk. First, two small cuts are made at the top of the hip bones.

We harvest the bone marrow from the iliac crest from the patients. And it's currently put into a centrifuge where we spin down the cells.

The stem cells are then mixed with platelet-rich plasma from the patient's own blood. Next, the doctor does a hip decompression, the standard procedure of opening the diseased bone at the top of the femur to release pressure and allow new bone to grow.

Now allows us, through a special instrumentation system that we've actually designed here, is to inject these cells into the area of the necrosis.

Director for the Mayo Clinic Center for Regenerative Medicine, Dr. Andre Terzic, says this is just one tantalizing example of how helping the body heal itself can lead to actual cures.

In other words, we have been able to go after the symptoms of disease. Increasingly, with the advances in technology, we'll be able to go after the root cause of the problem.

Dr. Sierra says, for most of his patients, stem cell therapy means their hip replacement can wait, hopefully indefinitely.

Then the 80% of the patients, we have been able to halt the progression, at least between two and five years.

For the Mayo Clinic News Network, I'm Dennis Douda.

Osteonecrosis of the hip is a disease in which blood supply to the hip is disrupted, causing the death of bone cells in the hip. In advanced stages, the disease can lead to debilitating pain, destruction of the hip joint and loss of mobility. At this point, hip replacement may be required.

Teams composed of bone specialists, biologists and engineers at Mayo Clinic are investigating the potential of simple hip decompression, a new regenerative technique, for patients with early stages of the disease.

Today, early-stage osteonecrosis of the hip is commonly treated with core decompression, an inpatient, invasive procedure in which a surgeon drills into the hipbone to remove dead areas of bone.

In contrast, simple hip decompression is a less invasive outpatient procedure in which a surgeon makes a small hole outside the hip and taps into the diseased area. A mixture of blood and progenitor cells taken from the patient's bone marrow is then delivered into the hipbone to restore function.

Mayo Clinic physicians and researchers are continuing to refine this procedure. In the future, simple hip decompression may give clinicians an effective way to regenerate diseased hip tissue, delaying or eliminating the need for hip replacement in people with osteonecrosis of the hip.

For more information, visit the Young Hip Clinic website or call 507-284-9217.