[Stem cell implant with neck-head decompression for aseptic necrosis of the femoral head]. / Implante de células madre con descompresión cérvico-cefálica por necrosis aséptica de la cabeza femoral.

Adult aseptic necrosis of the femoral head progresses from its reversible phase, stages I-II-III (Ficat-ARCO), to stages IV-V coxarthrosis, and this represents a health problem. An observational, descriptive, prospective, case-series type of study was conducted to prove the hypothesis that the boring decompression of the femoral neck-head cancellous layer, together with the local implantation of multipotent adult autologous stem cells processed according to Ficoll at approximate amounts of 16.1 x 10(6) cells/ml, is the treatment of choice for stages I-II-III of aseptic necrosis of the femoral head. These cells create the necessary tissue conditions to preserve the structure of the femoral head thus avoiding or delaying its degeneration and the resulting prosthetic arthroplasty. A total of 16 patients with a diagnosis of stages I-II-III aseptic necrosis of the hip, ages 40-70, all of whom were at the reversible stage and accepted the above mentioned procedure, were included. The evaluation was conducted in June 2011 applying Harris' pain-function scale. Its score was used to determine the mean, the standard deviation and the median. Pain relief and functional recovery without surgical or immune complications were proven. According to Harris' score, 3 stage-III patients were under the median. One stage-III patient required prosthetic arthroplasty, so 93.7% of the patients retained their femoral head more than 2 years after the surgery. We conclude that the proposed procedure is the procedure of choice for stages I-II and it makes us be more selective in the case of stage III necrosis.

[Multiple myeloma in young adults]. / Mieloma múltiple en el adulto joven.

Two unusual cases of multiple myeloma are studied. The patients were young (27 and 36 year old respectively), and showed a slowly progressing disease and a poor response to therapy. This confirms the criterion that chemotherapy is only useful in symptomatic and progressive cases of multiple myeloma.