Volume 26, Issue 120, February 2022

Core decompression with Bone Marrow Aspirate Concentrate (BMAC) - Halting the progression in early AVN head of femur

Ganesh MT^1♦, Saravanan P², Arvind Natarajan K³

¹Senior Resident, Department of Orthopaedics, Sree Balaji Medical College and Hospital, BIHER, Chrompet, Chennai- 600044, Tamil Nadu, India
²Professor, Department of Orthopaedics, Sree Balaji Medical College and Hospital, BIHER, Chrompet, Chennai- 600044, Tamil Nadu, India
³Junior Resident, Department of Orthopaedics, Sree Balaji Medical College and Hospital, BIHER, Chrompet, Chennai- 600044, Tamil Nadu, India

^♦Corresponding author
Senior Resident, Department of Orthopaedics, Sree Balaji Medical College and Hospital, BIHER, Chrompet, Chennai, Tamil Nadu, India

ABSTRACT

Hip pain in young adults could be due to femoral head avascular necrosis which has an indistinct etiology. A delay in the diagnosis and treatment, around 70-80% of the hips progresses to secondary osteoarthritis. Various treatment modalities have been described in the literature for early AVN hip with variable outcome. Early diagnosis and appropriate intervention could halt the progression, hence preserving the hip joint. However, if the disease progress, the femoral head collapses leading to secondary degeneration, and the surgeon would be left with Total Hip Arthroplasty (THA) as the treatment option. THA in young patients may invariably require revision replacement surgeries future in their lifetime and hence a good treatment modality is essential for early AVN to delay the need for arthroplasty. This case report focuses on a 28 year old male patient who came with left hip pain for the past two months with no history of any significant trauma. A possibility of ANV was considered and MRI taken. MRI showed a vascular necrosis grade II of left femoral head. Core decompression (CD) followed by Bone Marrow Aspirate Concentrate (BMAC) was then carried out for the patient under image intensifier guidance. Earlier MRI imaging helped in early diagnosis and intervention to prevent progression of the disease. The addition of Bone Marrow Aspirate resulted in better osseous regeneration.

Keywords: Avascular necrosis, Bone Marrow Aspirate Concentrate, core decompression, hip pain

Medical Science, 2022, 26, ms43e1955

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DOI: https://doi.org/10.54905/disssi/v26i120/ms43e1955

Published: 26 January 2022