[Treatment of early avascular necrosis of femoral head by core decompression and transplantation of human hepatic growth factor gene-modified osteoblasts: experiment with rabbits].

OBJECTIVE: To evaluate the effects of transplantation of human hepatocyte growth factor (hHGF) gene-modified osteoblasts combined with core decompression in treatment of avascular necrosis of femoral head (ANFH).

METHODS: The plasmid pcDNA3.1(+)-hHGF containing hHGF gene was constructed. Osteoblasts were isolated from fetal rabbits, cultured, and transfect3d with the plasmid pcDNA3.1(+)-hHGF or blank plasmid pcDNA3.1(+), or used as controls. Thirty-six adult New Zealand rabbits were made into ANFH models, underwent core decompression, and were randomly divided into 3 groups. Group A, transplanted with osteoblasts transfected with pcDNA3.1(+)-hHGF plasmid, Group B, transplanted with osteoblasts not transfected with pcDNA3.1(+)-hHGF plasmid, and Group C, injected with PBS medium. 2, 4, and 8 weeks later samples of femoral head were obtained to undergo CT, histological examination, and capillary ink infusion so as to observe the angiogenesis and osteogenesis.

RESULTS: The pcDNA3.1(+)-hHGF transfected osteoblasts showed stable expression of hHGF. The numbers of newly formed vessels of the femoral heads of the group transfected with pcDNA3.1(+)-hHGF-transfected osteoblasts 2 and 4 weeks later were (29.47 +/- 1.64) and (34.02 +/- 1.72)/cm2 respectively, both significantly higher than those of the group transfected with blank plasmid-transfected osteoblasts [(20.61 +/- 1.91) and (25.57 + 2.20)/cm2 respectively, both P <0. 01]. Eight weeks later the numbers of mature trabecular bone and bone marrow of Groups A and B were significantly higher than those of Group C.

CONCLUSION: Core decompression combined with transplantation of HGF gene-modified osteoblasts promotes angiogenesis, enhances bone formation, and improves the restoration of avascular necrosis of femoral head.