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Yale surgeons use younger patients’ stem cells to prevent hip replacements

NEW HAVEN, Conn. (WTNH) — Some Yale Medicine doctors are seeing younger patients with a hip condition called avascular necrosis or osteonecrosis, which respond to a treatment using their own stem cells. The procedure is helping to prevent them from needing hip replacements.

“What we’re really trying to do here at Yale is prevent the need for a hip replacement,” Yale Medicine Orthopaedic hip and knee surgeon Dr. Daniel Wiznia said.

Wiznia says he sees this condition in patients in their 30s and 40s. He uses patients’ own stem cells to help their bodies repair themselves. It works when the blood supply to the hip has been injured.

X-ray of a hip that has collapsed from osteonecrosis of the femoral head. Courtesy: Daniel Wiznia, MD

The condition can be caused by a few things. One is trauma.

“If you had a hip dislocation or a bad fall on your hip, it can injure the blood supply to the ball and socket joint,” Wiznia explains.

Then the hip does not receive nutrients from the blood supply that it needs to survive and can collapse.

The condition is also seen in patients who take high doses of steroids for conditions.

“Let’s say asthma or an autoimmune disease or if they have a transplant, those patients are at a high risk for this.”

Wiznia also sees patients who drink a lot of alcohol because the blood supply to the hip is filled with small vessels.

“Alcohol doesn’t really damage the large vesselsm but it can cause some of the small vessels to sclerose and become scarred and then they can clot off.”

He points out that it is not a condition called osteoarthritis, where overweight patients and others can have bone-on-bone hip issues and usually need a hip replacement.

“We know if you don’t have this stem cell procedure, 50% of these hips are going to collapse,” Wiznia said. “If you have the procedure there’s a 75% chance we can prevent the collapse.”

Orthopedic surgeons typically see this happening in both hips eventually, with results very encouraging, giving those younger patients their mobility back.