Percutaneous Autologous Bone-Marrow Grafting for Nonunions

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

doi:10.2106/00004623-200609001-00015

Cited by 155 publications

(40 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparing patient populations with less than 2,000 CFU‐F/ml ( n = 9) and greater than 2,000 CFU‐F/ml ( n = 11), patients with greater progenitor cell concentrations demonstrated statistically significantly greater improvements in pain scores between treatment and 3 months and between 3 and 6 months. This result of a critical CFU‐F concentration (2,000/ml) may be analogous to the clinical findings of Hernigou et al that tibial nonunion fractures and supraspinatus tendon (rotator cuff) tear repairs require greater than 1,500 CFU‐F/ml of BMC injectate to heal . No correlation could be established between CFU‐F concentration and patient age due to the inherent variability of CFU‐F frequency and TNC concentration between patients based on health and bone marrow aspiration technique.…”

Section: Discussionsupporting

confidence: 75%

Percutaneous Injection of Autologous Bone Marrow Concentrate Cells Significantly Reduces Lumbar Discogenic Pain Through 12 Months

Pettine¹,

et al. 2014

View full text Add to dashboard Cite

Degenerative disc disease (DDD) induces chronic back pain with limited nonsurgical options. In this open label pilot study, 26 patients (median age 40 years; range 18-61) received autologous bone marrow concentrate (BMC) disc injections (13 one level, 13 two levels). Pretreatment Oswestry disability index (ODI) and visual analog scale (VAS) were performed to establish baseline pain scores (average 56.5 and 79.3, respectively), while magnetic resonance imaging was independently scored according to the modified Pfirrmann scale. Approximately 1 ml of BMC was analyzed for total nucleated cell (TNC) content, colony-forming unit-fibroblast (CFU-F) frequency, differentiation potential, and phenotype characterization. The average ODI and VAS scores were reduced to 22.8 and 29.2 at 3 months, 24.4 and 26.3 at 6 months, and 25.0 and 33.2 at 12 months, respectively (p .0001). Eight of twenty patients improved by one modified Pfirrmann grade at 1 year. The average BMC contained 121 3 10 6 TNC/ml with 2,713 CFU-F/ml (synonymous with mesenchymal stem cells). Although all subjects presented a substantial reduction in pain, patients receiving greater than 2,000 CFU-F/ml experienced a significantly faster and greater reduction in ODI and VAS. Subjects older than 40 years who received fewer than 2,000 CFU-F/ml experienced an average pain reduction of 33.7% (ODI) and 29.1% (VAS) at 12 months, while all other patients' average reduction was 69.5% (ODI, p 5 .03) and 70.6% (VAS, p 5 .01). This study provides evidence of safety and feasibility in the nonsurgical treatment of DDD with autologous BMC and indicates an effect of mesenchymal cell concentration on discogenic pain reduction. STEM CELLS 2015;33:146-156

show abstract

Section: Discussionsupporting

confidence: 75%

Percutaneous Injection of Autologous Bone Marrow Concentrate Cells Significantly Reduces Lumbar Discogenic Pain Through 12 Months

Pettine¹,

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Additionally, as cell-based therapies are already used in musculoskeletal pathologies, such as bone fracture, pseudarthrosis and osteochondral defects [8, 9], we explored the potential of priming BM-derived hMSCs towards the osteogenic lineage in order to accelerate tissue regeneration upon reimplantation. We explored two distinct priming strategies: (1) the use of acoustic energy applied on BM and (2) varying the initial culture conditions of the isolated hMSCs.…”

Section: Introductionmentioning

confidence: 99%

Means of enhancing bone fracture healing: optimal cell source, isolation methods and acoustic stimulation

et al. 2016

View full text Add to dashboard Cite

BackgroundThe human body has an extensive capacity to regenerate bone tissue after trauma. However large defects such as long bone fractures of the lower limbs cannot be restored without intervention and often lead to nonunion. Therefore, the aim of the present study was to assess the pool and biological functions of human mesenchymal stromal cells (hMSCs) isolated from different bone marrow locations of the lower limbs and to identify novel strategies to prime the cells prior to their use in bone fracture healing. Following, bone marrow from the ilium, proximal femur, distal femur and proximal tibia was aspirated and the hMSCs isolated. Bone marrow type, volume, number of mononuclear cells/hMSCs and their self-renewal, multilineage potential, extracellular matrix (ECM) production and surface marker profiling were analyzed. Additionally, the cells were primed to accelerate bone fracture healing either by using acoustic stimulation or varying the initial hMSCs isolation conditions.ResultsWe found that the more proximal the bone marrow aspiration location, the larger the bone marrow volume was, the higher the content in mononuclear cells/hMSCs and the higher the self-renewal and osteogenic differentiation potential of the isolated hMSCs were. Acoustic stimulation of bone marrow, as well as the isolation of hMSCs in the absence of fetal bovine serum, increased the osteogenic and ECM production potential of the cells, respectively.ConclusionWe showed that bone marrow properties change with the aspiration location, potentially explaining the differences in bone fracture healing between the tibia and the femur. Furthermore, we showed two new priming methods capable of enhancing bone fracture healing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12896-016-0318-1) contains supplementary material, which is available to authorized users.

show abstract

“…Hernigoub et al 2005conducted a retrospective study in 60 tibial non-unions to evaluate the effect of progenitor cells present in autologous bone marrow concentrate, in bone healing for atrophic non-union fractures. Their study results indicated that the average nucleated cells present in the bone marrow concentrate were 51 x10 3 /µL and bone union was observed in 53 patients out of the 60 treated, concluding that number of progenitor cells in the injected bone marrow play an important role in safely and effectively treating atrophic non-union fractures [15]. In a prospective study by Goel et al results of bone marrow grafting in 20 tibial NUF patients were presented.…”

Section: Discussionmentioning

confidence: 97%

valuation of Safety and Preliminary Effectiveness of Point-of-Care Cell Processing System: An Observational Study

Gupta¹,

Suthar²,

Sethi³

et al. 2018

Stem Cells Regen Med

View full text Add to dashboard Cite

The potential of cell therapy in treating incurable and irreversible diseases has been proven to be safe and feasible with varying degrees of success in medical fraternity. In the past decade, there has been a steady increase in the development of advanced point-of-care cell processing technologies and intra-operative procedures that integrate autologous cell-based therapy with conventional surgical procedure in a single sitting, have emerged as an exciting approach in regenerative medicine and cell therapy field. Point-of-care (POC) cell processing devices are automatic, closed systems that allow rapid processing of whole tissue to the desired cell population at the patient's bedside, at an affordable cost. This observational study evaluates the safety and feasibility of a rapid point-of-care technology, the Res-Q™ 60 system used for processing bone marrow and/or peripheral blood intraoperatively for treating patients with various clinical indications who were administered the cell therapy product either as a standalone treatment or in conjunction with standard-of-care treatment. The data from 254 patients treated using either Bone Marrow Concentrate (BMC) or Platelet Rich Plasma (PRP) produced by Res-Q™ 60 devices was observed and analysed for device performance including cellularity, sterility and safety. The cellular output from Res-Q™ 60 BMC and PRP devices showed a significantly high MNC recovery of 71.35% ± 2.10 (SD) and platelet recovery of 78.3% ± 3.0 (SD), respectively. All the samples were sterile with no bacterial or fungal growth and all the patients tolerated the device output i.e. BMC or PRP well with no related adverse events (SAEs/ AEs). Therefore, the Res-Q™ 60 BMC and PRP devices were found to be safe, feasible and preliminary effective for autologous cellular therapy at the point-of-care.

show abstract

Percutaneous Autologous Bone-Marrow Grafting for Nonunions

Cited by 155 publications

References 3 publications

Percutaneous Injection of Autologous Bone Marrow Concentrate Cells Significantly Reduces Lumbar Discogenic Pain Through 12 Months

Percutaneous Injection of Autologous Bone Marrow Concentrate Cells Significantly Reduces Lumbar Discogenic Pain Through 12 Months

Means of enhancing bone fracture healing: optimal cell source, isolation methods and acoustic stimulation

valuation of Safety and Preliminary Effectiveness of Point-of-Care Cell Processing System: An Observational Study

Contact Info

Product

Resources

About