Osteonecrosis or Avascular Necrosis of the Scaphoid treated with Stem Cells

The scaphoid and lunate bone are the two major carpal bones in the wrist. The use of Regenerative Medicine and Stem Cell Therapy are of great interest in cases of AVN. Osteonecrosis or avascular necrosis of the scaphoid is also sometimes referred to as Preisers disease. This is conflicting as it’s more common usage now is for idiopathic cases of scaphoid AVN. However, in 1919 Preiser described the condition in 5 patients all of whom had trauma, and three of the five had fractures.

DEFINITION
Osteonecrosis or AVN of the scaphoid occurs by definition when the blood supply to the scaphoid become disrupted leading to bone cell death or necrosis. This may arise from arterial or vascular occlusion (such as in vascular congestion), it may also occur by elevated intra medullary pressure.

SYNONYMS
Avascular necrosis
Osteonecrosis
Ischemic necrosis
Aseptic necrosis
Bone infarction

CAUSES
Trauma
Excessive corticosteroid use
Excessive alcohol use
Connective tissue diseases
Sickle cell disease
Chemotherapy
Radiation therapy
Idiopathic (Unknown)

DIAGNOSIS
X-Rays
Bone scan
MRI

TREATMENT
Traditionally resist or immobilization with a cast or splint are employed. If this fails often surgical remedies are recommended. These may include surgical pins, fusion of the wrist or even the trial of an artificial bone. All of these surgical procedures are difficult and do not carry the highest success rate. This is particularly foreboding for athletes where their career may be ended by AVN. Regenerative Medicine and Stem Cell Therapy are becoming more popular considerations for AVN. Dennis M. Lox, MD, has utilized Stem Cell Therapy in a variety of patients with AVN especially athletes. Dr. Lox has treated numerous patients with scaphoid AVN with Stem Cell Therapy successively, even returning them to collegiate sports. Stem Cell Therapy is a viable alternative to surgery when confronted with AVN.