Quantitative assessment of growth factors in reaming aspirate, iliac crest, and platelet preparation

Schmidmaier, G.; Herrmann, Sebastian; Green, J.; Weber, Timothy G.; Scharfenberger, Angela; Haas, Norbert; Wildemann, Britt

doi:10.1016/j.bone.2006.05.023

Cited by 242 publications

(143 citation statements)

References 42 publications

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“…The volume of bone graft (average, 40.3 mL; range, 25-75 mL) reported in this study is slightly lower than the range reported in the literature (range, 30-90 mL) [21,24]. We are unaware of comparative figures for Fig.…”

Section: Discussioncontrasting

confidence: 59%

Bone Graft Harvest Using a New Intramedullary System

Belthur

Conway

Jindal

et al. 2008

Clinical Orthopaedics &Amp; Related Research

149

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Obtaining autogenous bone graft from the iliac crest can entail substantial morbidity. Alternatively, bone graft can be harvested from long bones using an intramedullary (IM) harvesting system. We measured bone graft volume obtained from the IM canals of the femur and tibia and documented the complications of the harvesting technique. Donor site pain and the union rate were compared between the IM and the traditional iliac crest bone graft (ICBG) harvest. Forty-one patients (23 male, 18 female) with an average age of 44.9 years (range, 15-78 years) had graft harvested from long bones using an IM harvest system (femoral donor site, 37 patients; tibial donor site, four patients). Forty patients (23 male, 17 female; average age, 46.4 years; range, 15-77 years) underwent anterior ICBG harvest. We administered patient surveys to both groups to determine pain intensity and frequency. IM group reported lower pain scores than the ICBG group during all postoperative periods. Mean graft volume for the IM harvest group was 40.3 mL (range, 25-75 mL) (graft volume was not obtained for the ICBG group). Using an intramedullary system to harvest autogenous bone graft from the long bones is safe provided a meticulous technique is used.

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Section: Discussioncontrasting

confidence: 59%

Bone Graft Harvest Using a New Intramedullary System

Belthur

Conway

Jindal

et al. 2008

Clinical Orthopaedics &Amp; Related Research

149

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“…Large volumes of graft can be obtained, with 40-90 ml harvests being reported [5,[7][8][9]. This graft has been shown to be 'comparable to iliac crest' in terms of osteoinductive growth factors [24], and high union rates have been reported in clinical series (50-90%) [5,[7][8][9]. It is noted that union rates reported by Belthur et al using RIA derived graft (37 of 41 cases) compared well with an iliac crest bone graft (ICBG) control group (32 of 40 cases) [7].…”

Section: Harvest Of Bone Graft and Mscsmentioning

confidence: 98%

Reamer-irrigator-aspirator indications and clinical results: a systematic review

Cox

Jones

McGonagle

et al. 2011

International Orthopaedics (SICOT)

126

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Background The 'reamer-irrigator-aspirator' (RIA) is an innovation developed to reduce fat embolism (FE) and thermal necrosis (TN) that can occur during reaming/ nailing of long-bone fractures. Since its inception its indications have expanded to include the treatment of long-bone osteomyelitis and as a harvester of bone graft/ mesenchymal stem cells (MSCs). Methods This study involved a systematic review, via Pubmed® and Google Scholar®, of English language sources (nine non-clinical studies, seven clinical studies and seven case reports) using the keywords: 'reamer', 'irrigator', 'aspirator' (1st May 2010). Sources were reviewed with reference to the RIAs efficacy in (1) preventing FE/TN, (2) treating long-bone osteomyelitis, (3) harvesting bone graft/MSCs, and (4) operating safely. Experimental data supports the use of the RIA in preventing FE and TN, however, there is a paucity of clinical data. Conclusions The RIA is a reliable method in achieving high volumes of bone graft/MSCs, and high union rates are reported when using RIA bone-fragments to treat nonunions. Evidence suggests possible effectiveness in treating long-bone osteomyelitis. The RIA appears relatively safe, with a low rate of morbidity provided a meticulous technique is used. When complications occur they respond well to conventional techniques. The RIA demands further investigation especially with respect to the optimal application of MSCs for bone repair strategies.

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“…Additionally, there can be large variations in concentrations of these factors from one sample to the next. 44 Demineralized bone matrix (DBM) is another product commonly utilized for fracture repair that contains many osteoinductive growth factors, but no cellular component. The collagen matrix of DBM provides some osteoconductive properties, and again, only small amounts of the most osteoinductive growth factor, BMP, are present with great variability from one product to another.…”

Section: Manipulating Mscs To Heal Bonementioning

confidence: 99%

“…Although many of the BMPs are known to be osteoinductive as noted above, only BMP2 and BMP7 are currently U.S. Food and Drug Administration-approved for use in bone repair, with delivery on collagen sponges. 44 This method requires the fracture site to be open, but other techniques such as injectable pastes and gene therapy approaches are being tested in the laboratory, and these could eliminate the need for an open site. 17,46 Osteoinductive coatings for fixation devices are also being developed and would offer the benefit of combined therapy (fixation and factor delivery) as well as a more sustained delivery.…”

Section: Manipulating Mscs To Heal Bonementioning

confidence: 99%