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Analysis of Cell Therapies Used in Clinical Trials for the Treatment of Osteonecrosis of the Femoral Head: A Systematic Review of the Literature.
Piuzzi, Nicolas S; Chahla, Jorge; Jiandong, Hao; Chughtai, Morad; LaPrade, Robert F; Mont, Michael A; Muschler, George F; Pascual-Garrido, Cecilia.
Afiliação
  • Piuzzi NS; Department of Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio; Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Chahla J; Steadman Philippon Research Institute, Vail, Colorado.
  • Jiandong H; Department of Orthopaedic Surgery, University of Colorado Denver, Denver, Colorado.
  • Chughtai M; Department of Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio.
  • LaPrade RF; Steadman Philippon Research Institute, Vail, Colorado; Department of Orthopaedic Surgery, The Steadman Clinic, Vail, Colorado.
  • Mont MA; Department of Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio.
  • Muschler GF; Department of Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio.
  • Pascual-Garrido C; Department of Orthopaedic Surgery, Washington University Orthopedics, St. Louis, Missouri.
J Arthroplasty ; 32(8): 2612-2618, 2017 08.
Article em En | MEDLINE | ID: mdl-28392136
BACKGROUND: Osteonecrosis of the femoral head (ONFH) is associated with regional loss of cells within bone, often resulting in pain and mechanical collapse. Our purpose was to analyze the cell-therapies used in clinical trials for the treatment of ONFH with regard to (1) cell-sources, (2) collection techniques, (3) cell-processing, (4) qualitative and quantitative characterizations, and (5) delivery methods. METHODS: A systematic review of the current literature on the use of cell therapies for the treatment of ONFH was performed. Studies with a level-of-evidence III or higher were evaluated. A total of 1483 articles were screened. Eleven studies met the criteria to be included in this review. RESULTS: Ten studies used bone-marrow, and 1 study used blood as the cell-source. Nine studies used freshly isolated tissue-derived nucleated cells from bone-marrow, mixed bone marrow-derived nucleated cells, 1 study used mixed blood-derived nucleated cells, and 1 study used culture-expanded cells derived from bone marrow aspirate. Cell dose varied from 2-million to 3-billion cells. Qualitative cell characterization of injected cells using surface markers was done by 5 studies using CD34. Two studies assayed the cell-population using a colony-forming-unit assay. CONCLUSION: There is a lack of standardization with respect to the quantitative and qualitative characterization of methods for cell-harvest, cell-processing, and cell-transplantation/delivery. Cell-therapy holds promise as a means of restoring local cell populations that are made deficient because of injury or disease. However, the orthopedic community and patients will benefit greatly by a greater investment in blinded, randomized, controlled trials and clinical effectiveness trials that embrace rigorous standards.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Necrose da Cabeça do Fêmur / Terapia Baseada em Transplante de Células e Tecidos Tipo de estudo: Clinical_trials / Guideline / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Argentina País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Necrose da Cabeça do Fêmur / Terapia Baseada em Transplante de Células e Tecidos Tipo de estudo: Clinical_trials / Guideline / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Argentina País de publicação: Estados Unidos