Efetividade da reabilitação pós implante de células mononucleares autólogas da medula óssea em osteonecrose da cabeça femoral em multicentros.

Abstract

This research aims to carry out an experimental pilot project to test the effectiveness of a physiotherapy protocol for the rehabilitation of patients after autologous mononuclear cell transplant surgery from bone marrow in osteonecrosis of the femoral head in multicenters to fill a gap in orthopedic physiotherapy. The adopted methodology comprised a case study. The assumption is to compare the interventions that were applied by researchers and collaborators in other centers. The quantitative and quasi-experimental approach, carried out in 19 patients, of both sexes, children and adults, diagnosed with osteonecrosis of the femoral head by the orthopedics service of the Professor Edgard Santos University Hospital of the Federal University of Bahia (UFBA), and selected for surgical treatment with implantation of autologous mononuclear cells from the bone marrow, and, later, submitted to physical therapy, in order to reduce joint pain and obtain better hip function. The selected patients were divided into treatment groups: Group 1- UFBA Physiotherapy Treatment (patients who underwent treatment through the protocol at UFBA in Salvador), Group 2-Multicenter Physiotherapy Treatment (patients who underwent treatment at the multicenters, accompanied in person by collaborating physical therapists who applied the same UFBA protocol) and Group-3- Control (patients not treated with the protocol). As results obtained, after the surgical procedure, the patients started physical therapy from the first postoperative week, following a physical therapy protocol. But, to date, only one N=19 patients underwent surgery to implant autologous bone marrow mononuclear cells in the hip due to the SARS-CoV2 pandemic, which results in non-statistical significance. Within this context, it became an experimental pilot project, in which the justification for potential results, found so far, allowed studies and future application in a greater number of patients undergoing physical therapy treatment. However, it was successful in 100% of patients oriented and treated with the protocol in the multicenters. Thus, the conclusion reached was that, given the results obtained, even from incipient data, they showed promise for the use of a physical therapy protocol in patients undergoing cell therapy for osteonecrosis of the femoral head, in partnership with multicenters, above all, because it understands that, together with the physical therapy medical service, it will make it possible to improve the management process, which is linked to the contributions it will provide, on a large scale, with the implementation of new public policies with the multicenters, minimizing operating costs and optimizing the existing resources in all instances – municipal, state and federal – which, consequently, will facilitate the process of rehabilitation of patients who qualify for the implantation of autologous mononuclear cells from the bone marrow in osteonecrosis of the femoral head.