Intralesional Injection of Bone Marrow Aspirate Concentrate for the Treatment of Osteonecrosis of the Knee Secondary to Systemic Lupus Erythematosus: A Case Report

An 18-year-old female patient with Systemic Lupus Erythematosus (SLE) and corticosteroid-associated extensive bilateral symptomatic knee Osteonecrosis (ON) (Ficat IV), treated with sequential intralesional injections of autologous bone marrow aspirate concentrate (BMAC) under ultrasound guidance. At...

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Bibliographic Details
Published inFrontiers in bioengineering and biotechnology Vol. 8; p. 202
Main Authors Kouroupis, Dimitrios, Ahari, Amir F, Correa, Diego, Shammaa, Riam
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 20.03.2020
Subjects
Bioengineering and Biotechnology
bone marrow aspirate concentrate
cellular therapy
endothelial progenitor cells
mesenchymal stem cells
osteonecrosis
systemic lupus erythematosus
systemic lupus erythematosus
bone marrow aspirate concentrate
endothelial progenitor cells
mesenchymal stem cells
bone regeneration
osteonecrosis
cellular therapy
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Summary:An 18-year-old female patient with Systemic Lupus Erythematosus (SLE) and corticosteroid-associated extensive bilateral symptomatic knee Osteonecrosis (ON) (Ficat IV), treated with sequential intralesional injections of autologous bone marrow aspirate concentrate (BMAC) under ultrasound guidance. At 3 months, pain was almost absent (VAS) and KOOS/WOMAC showed significant improvement sustained up to 24 months. At 12 months MRI indicated bone maturation, significantly reduced BM edema and subchondral fluid volume, and no collapse/fragmentation signs. The clinical and imaging significant improvement observed in this patient suggests that BMAC intralesional injections effectively restored the compromised bone structure. After larger studies, this technique can become an alternative to decompressing surgery for ON cases.
Bibliography:Reviewed by: Anselm Mak, National University of Singapore, Singapore; Enrico Lucarelli, Rizzoli Orthopedic Institute (IRCCS), Italy
Edited by: Bruce Alan Bunnell, Tulane University, United States
These authors have contributed equally to this work
This article was submitted to Tissue Engineering and Regenerative Medicine, a section of the journal Frontiers in Bioengineering and Biotechnology
ISSN:2296-4185
2296-4185
DOI:10.3389/fbioe.2020.00202