Core Decompression Augmented With Autologous Bone Marrow Aspiration Concentrate for Early Avascular Necrosis of the Femoral Head Lucas Arbeloa-Gutierrez,

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Presentation transcript:

Core Decompression Augmented With Autologous Bone Marrow Aspiration Concentrate for Early Avascular Necrosis of the Femoral Head Lucas Arbeloa-Gutierrez, M.D., Chase S. Dean, M.D., Jorge Chahla, M.D., Cecilia Pascual-Garrido, M.D. Arthroscopy Techniques Volume 5, Issue 3, Pages e615-e620 (June 2016) DOI: 10.1016/j.eats.2016.02.009 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 The patient is positioned supine on a fracture table with both feet secured in traction boots and internally rotated. A right hip setup is shown. Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Iliac bone marrow is obtained percutaneously through the use of bone marrow aspiration needles bilaterally. (ASIS, anterosuperior iliac spine.) Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 The PerFuse rod is placed over the skin to determine the anteroposterior skin markings on a right hip. (ASIS, anterosuperior iliac spine.) Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Fluoroscopy of a right hip: anteroposterior (A) and lateral (B) views. The trocar is advanced, making sure the location matches the area of avascular necrosis. Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Delivery of bone marrow aspiration concentrate (BMAC) through a disposable cannula in a right hip. Injection is performed directly into the necrotic zone. Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Bone graft is introduced using a syringe through the cannula. The bone graft is pushed into the canal with the use of a trocar rod in a right hip. Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 (A, B) Fluoroscopic images showing sequential filling of the tunnel with bone graft in a right hip. Arthroscopy Techniques 2016 5, e615-e620DOI: (10.1016/j.eats.2016.02.009) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions