Tuesday, February 24, 1998
Researcher brings bones back to life
HEALTH: New technique pioneered at UCLA may prevent hip
replacement
By Kathryn Combs
Daily Bruin Staff
She hikes, she walks and she sits, all without pain. A
miracle?
Though most take these activities for granted, Anne Donnelly
doesn¹t. Three years ago she could not do these things without
severe pain in her hips and knees, due to a condition called
avascular osteonecrosis  or bone death.
However, thanks to a new technique pioneered by UCLA researcher
Dr. Jay Lieberman, patients like Donnelly can walk a little
easier.
³I don¹t even think of the pain anymore,²
Donnelly said.
Osteoregeneration is a technique that may prevent the need for
total hip replacement.
Donnelly, now 38, has been taking prednisone, a steriod, which
led to the deterioration of her bones.
³I was getting pain especially in my left hip and it was
also affecting my knee,² Donnelly recounted.
³I would always push myself through the pain,² she
said.
While the cause is largely unknown, steroids such as prednisone
can lead to bone death. Other factors include trauma to the hip
joint causing dislocation, and chronic alcohol use.
In the new technique, termed osteoregeneration, Lieberman
modified an already existing technique called core
decompression.
³We drill a hole to get out as much of the dead bone as we
can,² Lieberman said.
However, according to Lieberman, this technique is controversial
within the medical community because this method can further weaken
the hip joint.
In core decompression, doctors drill a hole through the head of
the femur, the knobby end of the thigh bone. Doctors then remove
all the dead bone in the hope that new bone will develop.
But this technique is only effective in cases detected early,
according to Lieberman.
The new technique employs core decompression and combines it
with Bone Morphogenetic Protein (BMP), a bone-forming protein.
³What¹s happening is that BMP will help stimulate
these cells to make bone,² Lieberman said.
BMP was discovered by Dr. Marshall Urist in 1965 at UCLA.
³The mode of action is like a railroad switch, from fibrous
tissue to bone and bone marrow. It regulates the development of
bone,² Urist added.
Doctors also use a bone graft to complete the procedure and the
results have ranged from good to excellent.
³This technique has helped me immensely,² Donnelly
said.
³(Lieberman) thinks it is just a matter of time until I
have to have a hip replacement, but I do everything,² Donnelly
said.
Donnelly performs tasks from mowing the lawn, to weeding, to
taking mile-long hikes with her three kids.
³Sometimes it is difficult to make treatment decisions and
there are a number of different treatments,² Lieberman
said.
³We are offering this because we think it is a biological
solution to the problem,² he added.
Thus far, the procedure has been performed on 10 patients,
ranging from ages 29 to 57.
³We don¹t have enough data at this time to say that it
is better, but a lot of the other techniques have not been shown to
work,² Lieberman said. ³(However), it is a definite step
in the right direction.²
As a result of this procedure Donnelly is now able to perform a
number of activities without pain.
³Now I am pain-free active,²she said.
DERRICK KUDO
Dr. Jay Lieberman developed a new bone treatment that may reduce
the need for hip replacements.