Percutaneous Autologous Bone-Marrow Grafting for Nonunions

Hernigou, Philippe; Mathieu, G.; Poignard, Alexandre; Manicom, O.; Beaujean, F.; Rouard, Hélène

doi:10.2106/jbjs.f.00203

Cited by 186 publications

(134 citation statements)

References 4 publications

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“…After an injection of 2.000 IE heparine, an aspiration and concentration system (Marrowstim Ò , Biomed, Warsaw, IN) was used according to the guidelines of the manufacturer. 19,20 Briefly, 20 mL of bone marrow aspirate were used to create 3 mL of concentrate. The concentrate was transferred in a custom-made cell-seeding device (manufactured by the Institutional Central Research Laboratories of Hannover Medical School (MHH); Fig.…”

Section: Experimental Designmentioning

confidence: 99%

Bone Marrow-Derived Cell Concentrates Have Limited Effects on Osteochondral Reconstructions in the Mini Pig

Jagodzinski

Liu

Guenther

et al. 2014

Tissue Engineering Part C: Methods

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This study investigates the effects of seeding a chondrogenic and osteogenic scaffold with a bone marrowderived cell concentrate (BMCC) and reports the histological and mechanical properties 3 months after implantation in the miniature pig. Twenty defects (7 · 10 mm) were created in the femoral condyles of 10 miniature pigs. The defects were left empty (E), filled with the grafted cylinder upside down (U) or with a combined scaffold (S) containing a spongious bone cylinder (Tutobone Ò ) covered with a collagen membrane (Chondrogide Ò ). In a fourth group, the same scaffolds were implanted but seeded with a stem cell concentrate (S + BMCC). The animals were stained with calcein green after 2 weeks and xylenol orange after 4 weeks. After 3 months, the animals were sacrificed, and a mechanical analysis (Young's modulus), macroscopic, and histologic (ICRS Score) examination of the specimens was conducted. Young's modulus in the periphery was significantly lower for group E (67.5 -15.3 kPa) compared with untreated controls (171.7 -21.6 kPa, p < 0.04). Bone defects were smaller in group S (10% -8%) compared with E (27% -7%; p < 0.05). There was a trend toward smaller bony defects on comparing groups E and S + BMCC (11% -8%; p = 0.07). More red fluorescence was detected in group S + BMCC (2.3% -1.1%) compared with groups E (0.4% -0.2%) and U (0.5% -0.2%, p < 0.03). ICRS scores were higher for groups S (25.3 -3.8) and S + BMCC (26.2 -5.2, p < 0.01). In this animal model of osteochondral defects, stem cell concentrates enhance new bone apposition but fail to improve mechanical properties or histological appearance of cartilage regenerates in critical-sized defects.

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Section: Experimental Designmentioning

confidence: 99%

Bone Marrow-Derived Cell Concentrates Have Limited Effects on Osteochondral Reconstructions in the Mini Pig

Jagodzinski

Liu

Guenther

et al. 2014

Tissue Engineering Part C: Methods

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“…The harvest of autologous bone marrow has been developed in previous studies (Bielecki, 2006). Since bone marrow contains osteogenic progenitors, the injection of bone marrow is considered to have the potential for effective bone regeneration (Hernigou, 2006;Undale, 2009). The implantation of bone marrow can increase the local biology and optimize the potential of osteoprogenitors (Ohgushi, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…MSCs reimplantation was performed using a technique described by Hernigou et al (Hernigou, 2006). Under general anaesthesia, the patient was placed on the operating table in a supine position.…”

Section: Mscs Reimplantationmentioning

confidence: 99%

“…The bone marrow aspiration concentrate (BMAC) was injected slowly at a speed of 20 ml/minute in a controlled fashion. After injection, the trocars, with the stylet in place, was withdrawn slowly to blood clot gradually bit of trocar paths (Hernigou, 2006). The patient was asked to keep in the same position for the first hour to allow for cell attachment.…”

Section: Mscs Reimplantationmentioning

confidence: 99%

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Mini-invasive treatment for delayed or nonunion: the use of percutaneous autologous bone marrow injection

Thua¹,

Pham²,

Le³

et al. 2015

Biomed Res Ther

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Abstract-Delayed union or nonunion of bone fracture is becoming less frequent, but still remains a challenging clinical problem. Autologous cancellous bone grafting that is the gold standard method, often involves donor site morbidities and complications. Once these fractures have been mechanically stabilized, other local factors should be investigated to promote delayed healing. The purpose of this study was to evaluate the initial outcome of the percutaneous injection of autologous bone marrow after concentration for the treatment of delayed or nonunion. Our subjects included 10 patients (3 female, 7 male) with an average age of 28 years. All fractures were mechanically stabilized after accident.Delayed or nonunion affected the femur in 2 patients, the tibia in 5 patients, the humerus in 2 patients, and the ulna in 1 patient. Bone marrow aspirates were obtained from both the posterior superior iliac crest. Bone marrow aspiration concentrate was produced via density gradient centrifugation. Trocars were inserted in the delayed or nonunion gap under fluoroscopic guidance. The bone marrow aspiration concentrate was injected slowly. All of 10 delayed or nonunion healed after treatment with percutaneous injection of autologous bone marrow. The mean time for new bone formation was 3.3 months, for clinical union was 5.2 months, and for radiological union was 11.8 months. The result of current study is encouraging in the initial outcome and percutaneous bone marrow implantation could be an effective and safe treatment for delayed or nonunion.

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“…Another reason for choosing ADSCs was that a high number of stem cells were needed. In human clinical case reports, the injection of bone marrow derived stem cells (BDSCs) in atrophic tibia nonunion fractures have elicited successful bone healing, and it has been suggested that the efficacy of bone healing appears to be related to the number of osteoprogenitor cells injected (Hernigou et al, 2006). Adipose tissue was chosen as the stem cell source because it has a large number of stem cells compared with bone marrow.…”

Section: Discussionmentioning

confidence: 99%

Augmentation of bone healing of nonunion fracture using stem cell based tissue engineering in a dog: a case report

Lee¹,

Chung²,

Heo³

et al. 2009

Vet. Med. - Czech

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ABSTRACT:A 4-year-old, intact male crossbreed dog, weighing 27 kg, was referred for the treatment of a nonunion fracture. The radiographs revealed displacement of the radius and ulna bone fracture fragment and a sclerotic fracture end of the radius. Autologous adipose derived stem cells (ADSCs) were isolated and expanded ex vivo in a culture. The ADSCs (3.2 × 107 cells) were seeded on a composition scaffold made from hydroxyapatite (HA) and chitosan (CH) fibers. The seeded scaffold with ADSCs was placed on the fracture site and the bone fracture was stabilized. A sample of seeded scaffold with ADSCs was taken to evaluate the extent of cell attachment and morphology on the scaffold using scanning electron microscopy (SEM). SEM showed that ADSCs adhered to the scaffold well and many bone nodules formed from the bone matrix secreted by ADSCs. Three months after surgery, the nonunion had successfully healed with no complications. The application of a composition scaffold of HA and CH containing ADSCs can be used to treat a nonunion fracture by augmenting bone healing and may decrease the risk of surgical failure of nonunion fractures.

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Percutaneous Autologous Bone-Marrow Grafting for Nonunions

Cited by 186 publications

References 4 publications

Bone Marrow-Derived Cell Concentrates Have Limited Effects on Osteochondral Reconstructions in the Mini Pig

Bone Marrow-Derived Cell Concentrates Have Limited Effects on Osteochondral Reconstructions in the Mini Pig

Mini-invasive treatment for delayed or nonunion: the use of percutaneous autologous bone marrow injection

Augmentation of bone healing of nonunion fracture using stem cell based tissue engineering in a dog: a case report

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