Objective To investigate the therapeutic effects of the vacularized iliac graft for ischemic necrosis of the femoral head in Niger young patients with sickle cell disease. Methods From November 1998 to Apirl 2001, 12 patients(5 males and 7 females, aging 11-22 years) with sickle cell disease suffered from ischemic necrosis of the femoral head in 14 hips. The lesion was on one hip in 10 patients and on bilateral hip in 2 patients. Necrosis was classified as Ficat Stage Ⅲ-Ⅳ in all patients. Twelve hips in 12 patients were treated with vascularized iliac graft in Maradi Province Hospital of Niger. The effects were evaluated on the basis of the Harris hip score and radiological examination. Results The patients were followed up 24-30 months after operation(27.4 months on average). The clinical results were satisfactory though no radiological evidence of improvement was noted. The mean Harris hip score increased from 75 points to 90 points. Pain relief and hip function improvement were achieved in all patients. No patients needed revision during short-term follow-up of 24-30 months. Conclusion The method is recommendation for treatment of ischemic necrosis of the femoral head in the Ficat Stages Ⅲ- Ⅳ in young patients with sickle cell disease for pain relief and restoration of hip joint function. This procedure may prolong the timing and acting of total hip arthroplasty.

Avascular necrosis of the femoral head is caused by a multitude of etiologic factors and is associated with collapse with a risk of hip arthroplasty in younger populations. A focus on early disease management with the use of stem cells was proposed as early as 1985 by the senior author (PH). We undertook a systematic review of the medical literature to examine the progress in cell therapy during the last 30 years for the treatment of early stage osteonecrosis.
*Cell- and Tissue-Based Therapy ; Femur Head/*surgery ; Femur Head Necrosis/*surgery ; Humans ; *Mesenchymal Stem Cell Transplantation ; *Tissue Engineering