PMC9826853_01
Sagittal MRI T1 and T2 weighted images of the lumbar spine showing irrelevant findings.
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He sought his neurosurgeon for treatment, his neurological examination and X-rays were normal, an MRI of the lumbar spine was obtained and he was referred to the pain management clinic as his MRI revealed degenerative irrelevant findings of L1-L2 and L2-L3 but importantly an increased signal of the right femoral head on the T2 and STIR weighted images (Fig. 1).
Plain X-ray of the hips obtained at the start of the patient's complaint with no abnormalities.
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HHS was 42, and examination of the remaining musculoskeletal system was unremarkable, hip X-rays were normal while MRI confirmed the diagnosis of FICAT stage I osteonecrosis of the right femoral head which is also a stage 1 AVN of the femoral head based on the ARCO classification with normal X-ray and abnormal MRI. He had no history of blood transfusion, coagulopathy, or steroid use; all the biochemical studies were within normal limits (Fig. 2).
AD-MSCs preparation starts from liposuction of lower-abdomen fat then processing the aspartate in the kit and infringing the fat and filtering the product into AD-MSCs rich aspirate ready to be injected.
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The AD MSCs were prepared by utilizing a LIPOGEMS kit (Fig. 3), liposuction of abdomen fat was done after infiltration of 400 ml of saline and adrenaline (2 mug/ml) into the lower abdomen and then the lipoaspirate was processed using the kit with sterile saline solution to remove contaminants and rinsing and resizing the fat into smaller clusters and filtering it following manufacturer instructions to get 20 ml of LIPOGEMS final product ready to be injected.
On the lift T1 MRI weighted coronal image of the hips preoperatively and on the right 3 months postoperatively.
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At 3 months he had a very mild limp with occasional pain, especially while standing from a seat, and repeated MRI showed healed femoral head with a recession of the lesion, his HHS was 92 (Fig. 4, Fig. 5, Fig. 6).
Follow-up X-ray of the hips 16 months post-surgery.
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At 3 months he had a very mild limp with occasional pain, especially while standing from a seat, and repeated MRI showed healed femoral head with a recession of the lesion, his HHS was 92 (Fig. 4, Fig. 5, Fig. 6).