Regenerate augmentation with bone marrow concentrate after traumatic bone loss

Abstract

Distraction osteogenesis after post-traumatic segmental bone loss of the tibia is a complex and time-consuming procedure that is often complicated due to prolonged consolidation or complete insufficiency of the regenerate. The aim of this feasibility study was to investigate the potential of bone marrow aspiration concentrate (BMAC) for percutaneous regenerate augmentation to accelerate bony consolidation of the regenerate. Eight patients (age 22–64) with an average posttraumatic bone defect of 82.4 mm and concomitant risk factors (nicotine abuse, soft-tissue defects, obesity and/or circulatory disorders) were treated with a modified Ilizarov external frame using an intramedullary cable transportation system. At the end of the distraction phase, each patient was treated with a percutaneously injection of autologous BMAC into the centre of the regenerate. The concentration factor was analysed using flow cytometry. The mean follow up after frame removal was 10 (4–15) months. With a mean healing index (HI) of 36.9 d/cm, bony consolidation of the regenerate was achieved in all eight cases. The mean concentration factor of the bone marrow aspirate was 4.6 (SD 1.23). No further operations concerning the regenerate were needed and no adverse effects were observed with the BMAC procedure. This procedure can be used for augmentation of the regenerate in cases of segmental bone transport. Further studies with a larger number of patients and control groups are needed to evaluate a possible higher success rate and accelerating effects on regenerate healing.

Advancing biomaterials of human origin for tissue engineering

“…In any case, the exponential rate of progress in biotechnology has allowed for the immediate application of myriad novel therapies before clear evidence of benefit from randomized clinical trials. In addition to its fundamental science, the ease of on-site preparation of bone marrow-derived cells within the operating theater in the routine clinical setting, minimizing the specific risk of contamination and cell changes during ex vivo cell manipulation, suggests the great therapeutic potential of BMC for autologous cell-based therapy for bone or other tissue repair and regeneration [555,559,567]. …”

Improvement of Fat Graft Survival with Autologous Bone Marrow Aspirate and Bone Marrow Concentrate: A One-Step Method

“…Bone marrow aspirate and bone marrow concentrate have been proven to be beneficial in tissue regeneration and rejuvenation in both experimental and clinical studies. [34][35][36] Results of histologic evaluations, living tissue imaging, and immunohistological staining showed that bone marrow aspirate and bone marrow concentrate were beneficial in fat survival quality, adipocyte viability, and angiogenesis of fat grafts. These results confirmed our hypothesis, and are in accordance with previous studies.…”

“…These results confirmed our hypothesis, and are in accordance with previous studies. [34][35][36] Observations of cells expressing both PKH26 and BODIPY and the PKH26/lectin-positive bone marrow concentrate cells demonstrated that bone marrow concentrate cells could improve fat graft survival by multilineage differentiation and participate in adipogenesis and angiogenesis.…”

Repair of segmental long-bone defects by stem cell concentrate augmented scaffolds: a clinical and positron emission tomography - computed tomography analysis

“…Both BMAC groups revealed better results than patients treated with bone marrow aspirates without concentration. Gessmann et al [16] investigated the effect of percutaneous application of BMAC into the regenerated bone section in eight patients with tibial bone defects who underwent segmental transport with a modified Ilizarov external fixation device. They found sufficient bone healing and no adverse events in all patients at a mean follow-up of ten months [16].…”