Core decompression combined with local DFO administration loaded on Polylactic Glycolic Acid scaffolds for the treatment of osteonecrosis of the femoral head: A pilot study

Abstract

Abstract Background Deferoxamine (DFO) angiogenesis induction potential has been demonstrated in earlier studies, but not in the osteonecrosis of the femoral head (ONFH). In this study, we evaluated the outcome of ONFH treated with combined core decompression and local DFO administration loaded on Polylactic Glycolic Acid (PLGA). Patients and Methods‎: ‎In a pilot experimental study‎,‎‏ six patients (‏‎10 ‎hips‎) ‎with early‎-‎stage non‎-‎traumatic ONFH were treated by ‏core decompression, and concurrent injection of local DFO ‎loaded on PLGA scaffold into the subchondral femoral head. Outcome measures were evaluated ‎before the surgery and 12 and 24 months after the surgery and included visual analog scale (VAS) for ‎pain, modified Merle d'Aubigné-Postel (MAP) score for hip function, and rate of osteonecrosis ‎assessed by the modified Kerboul angle. The incidence of the collapse was assessed by CT ‎scanning.‎ Results The mean MPA score was 14.7 ± 1.16 before the surgery and 16.7 ± 1.41 one year after the surgery (P = 0.004). The mean VAS for pain was 4.7 ± 1.25 before the surgery and 1.8 ± 1.03 one year after the surgery (P = 0.005). The mean Kerboul angle was 219 ± 58.64 before the operation and 164.6 ± 41.82 one year after the operation (P < 0.001). Osteonecrosis progression or collapse was not seen in any of the patients at the final follow-up. No postoperative side effect attributed to the DFO was noticed, as well. Conclusion The mean MPA score was 14.7 ± 1.16 before the surgery and 16.7 ± 1.41 one year after the surgery (P = 0.004). The mean VAS for pain was 4.7 ± 1.25 before the surgery and 1.8 ± 1.03 one year after the surgery (P = 0.005). The mean Kerboul angle was 219 ± 58.64 before the operation and 164.6 ± 41.82 one year after the operation (P < 0.001). Osteonecrosis progression or collapse was not seen in any of the patients at the final follow-up. No postoperative side effects attributed to DFO were noticed, as well. Trial registration: IR.IUMS.FMD.REC.1397.281