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Updated: Jun 30, 2026
Use of Human Perivascular Stem Cells for Bone Regeneration
Published on: May 25, 2012
Cell-based therapies for osteonecrosis of the femoral head
Kevin B Jones1, Tara Seshadri2, Roselynn Krantz3
1Division of Orthopedics, Department of Surgery, Mount Sinai Hospital, Toronto, Ontario; University of Toronto, Toronto, Canada.
Insights
Osteonecrosis of the femoral head is a disabling complication after hematopoietic cell transplants (HCT), often linked to steroid use. Mesenchymal stromal cell therapy shows promise as a novel treatment option.
Area of Science:
- Orthopedics and Regenerative Medicine
- Hematology and Oncology
Background:
- Osteonecrosis of the femoral head (ONFH) is a debilitating complication following hematopoietic cell transplants (HCT).
- Steroid exposure, particularly for graft-versus-host disease, is a primary risk factor for ONFH in HCT recipients.
- Current treatments for ONFH are primarily surgical, including decompression, bone grafting, or hip arthroplasty.
Purpose of the Study:
- To provide an overview of osteonecrosis, focusing on its occurrence in HCT recipients.
- To introduce cell-based therapies as a potential treatment for ONFH in this patient population.
Main Methods:
- Review of existing literature on osteonecrosis of the femoral head.
- Emphasis on risk factors, clinical presentation, and current management strategies in HCT recipients.
- Exploration of emerging cellular therapies, specifically mesenchymal stromal cells.
Main Results:
- ONFH is a significant complication in HCT recipients, strongly associated with corticosteroid administration.
- Surgical interventions are the current standard of care but have limitations.
- Cellular therapies, particularly those involving mesenchymal stromal cells, are emerging as a promising alternative or adjunct treatment.
Conclusions:
- Osteonecrosis of the femoral head poses a considerable challenge in HCT survivors.
- Mesenchymal stromal cell therapy represents a novel and potentially effective therapeutic avenue for ONFH.
- Further research into cell-based treatments could revolutionize the management of ONFH in HCT patients.
Abstract:
Osteonecrosis of the femoral head is a disabling condition and a known complication of hematopoietic cell transplants (HCT). It is characterized by empty lacunae in the osseous matrix and necrotic marrow elements. The most important risk factor in HCT recipients is steroid exposure, frequently in the context of graft-versus-host disease. Current treatment is surgical, and involves decompression of the affected area and the use of bone grafts or hip arthroplasty. Cellular-based therapies are now under investigation, and can be used in addition to, or instead of, invasive surgery. This review presents an overview of osteonecrosis with particular emphasis on HCT recipients and introduces the role of cell therapy, especially with mesenchymal stromal cells, as a promising new treatment.
