Avascular Necrosis of the Sesamoid Bones: Stem Cells an Option?

The sesamoids are small bones on the pad of the foot. Typically the sesamoids are overlooked as causes of foot pain. The sesamoids have been involved in local irritation (sesamoiditis), stress fractures, and rarely avascular necrosis.

Runners, long distance sports or occupations such as military troops on long marches have been known to develop sesamoid problems.

Avascular necrosis (AVN) is characterized by the disruption of blood flow to an area of bone, which then results in ischemic necrosis (bone cell death). Some AVN may result in self collapse of the bone, which can lead to degenerative arthritis of the region.

Stem cells may exert a positive effect on AVN areas by controlling inflammation which can propagate arthritis development and pain.

Stem cells may also create a reparative effect by the formation of new blood vessels. In AVN the creation of collateral blood flow is similar to repair in coronary artery disease.

Stem cells may also foster the formation of new bone cells by differentiation or the recruitment of progenitor cells (precursor cells).

The reparative properties of stem cell sources, may be a viable treatment approach for avascular necrosis (AVN) of the sesamoid bones.