Osteonecrosis of the femoral head (ONFH) is a debilitating disease that may progress to femoral head collapse and subsequently, degenerative arthritis. Although injection of bone marrow-derived mononuclear cells (BMMCs) is often performed with core decompression (CD) in the early stage of ONFH, these treatments are not always effective in prevention of disease progression and femoral head collapse. We previously described a novel 3D printed, customized functionally-graded scaffold (FGS) that improved bone growth in the femoral head after CD in a normal healthy rabbit, by providing structural and mechanical guidance. The present study demonstrates similar results of the FGS in a rabbit steroid-induced osteonecrosis model. Furthermore, the injection of BMMCs into the CD decreased the osteonecrotic area in the femoral head. Thus, the combination of FGS and BMMC provides a new therapy modality that may improve the outcome of CD for early stage of ONFH by providing both enhanced biological and biomechanical cues to promote bone regeneration in the osteonecrotic area.

股骨头坏死 (ONFH) 是一种使人衰弱的疾病，可能会发展为股骨头塌陷，进而发展为退行性关节炎。尽管在 ONFH 的早期阶段通常会通过核心减压 (CD) 进行骨髓源性单核细胞 (BMMC) 注射，但这些治疗并不总是能有效预防疾病进展和股骨头塌陷。我们之前描述了一种新型 3D 打印、定制的功能分级支架 (FGS)，它通过提供结构和机械指导来改善正常健康兔子 CD 后股骨头的骨生长。本研究表明 FGS 在兔类固醇诱导的骨坏死模型中也得到了类似的结果。此外，将 BMMC 注射到 CD 中减少了股骨​​头坏死面积。因此，FGS 和 BMMC 的组合提供了一种新的治疗方式，可以通过提供增强的生物学和生物力学线索来促进骨坏死区域的骨再生，从而改善 ONFH 早期 CD 的结果。