Existence of mesenchymal stem cells in sites of atrophic nonunion

Abstract

ObjectivesNonunion is one of the most troublesome complications to treat in orthopaedics. Former authors believed that atrophic nonunion occurred as a result of lack of mesenchymal stem cells (MSCs). We evaluated the number and viability of MSCs in site of atrophic nonunion compared with those in iliac crest.MethodsWe enrolled five patients with neglected atrophic nonunions of long bones confirmed by clinical examinations and plain radiographs into this study. As much as 10 ml bone marrow aspirate was obtained from both the nonunion site and the iliac crest and cultured for three weeks. Cell numbers were counted using a haemocytometer and vitality of the cells was determined by trypan blue staining. The cells were confirmed as MSCs by evaluating their expression marker (CD 105, CD 73, HLA-DR, CD 34, CD 45, CD 14, and CD 19). Cells number and viability were compared between the nonunion and iliac creat sites.ResultsAfter three weeks, numbers of 6.08×106 cells (sd 2.07) and 4.98×106 cells (sd 1.15) were obtained from the nonunion site and the iliac crest, respectively, with viability of 87.1% (81.7% to 90.8%) and 89.8% (84.7% to 94.5%), respectively. No differences was found between the two sources of MSCs regarding cells number (p = 0.347) and viability (p = 0.175).ConclusionsOur findings showed the existence of MSCs in the site of atrophic nonunion, at a similar number and viability to those isolated from the iliac crest.

Osteogenic potency of human bone marrow mesenchymal stem cells from femoral atrophic non-union fracture site

“…In our previous study, we revealed the existence of mesenchymal stem cells in atrophic non-union fracture site [8]. However, in our, we did not evaluate the osteogenic potency of those cells in the study.…”

“…In our previous study, we found that MSCs exist in the site of atrophic non-union fracture [8]. However, whether they are capable to differentiate into osteoblast was not evaluated.…”

Mechanobiology in the management of mobile atrophic and oligotrophic tibial nonunions

“…8,[23][24][25] The biological inactivity of atrophic bone ends has been questioned by authors in recent literature. 24,[26][27][28][29] Brownlow et al 26 and Reed et al 27 showed that the vascularity of atrophic nonunions is comparable to that seen in fresh fractures and hypertrophic nonunions. Ismail et al 29 showed that mesenchymal stem cells were present at the site of atrophic nonunions at similar number and viability than those isolated from the iliac crest.…”

“…24,[26][27][28][29] Brownlow et al 26 and Reed et al 27 showed that the vascularity of atrophic nonunions is comparable to that seen in fresh fractures and hypertrophic nonunions. Ismail et al 29 showed that mesenchymal stem cells were present at the site of atrophic nonunions at similar number and viability than those isolated from the iliac crest. Sun et al 28 postulated that these mesenchymal stem cells were temporarily quiescent and could be reactivated under certain conditions.…”

Autologous Bone Marrow Stem Cells combined with Allograft Cancellous Bone in Treatment of Nonunion

“…Autologous cancellous bone gra ment of many bone defects, accelerating fracture healing, and reducing complications (Giannotti et al, 2013b;Ismail et al, 2013;Ohgushi, 2014). According to the above mentioned "diamond concept", BM-MSCs provide the most appropriate cells for inducing bone repair, as they have a strong osteogenic potential and are easily obtained by culturing iliac crest aspirates (Akram et al, 2014;Gómez-Barrena et al, 2015).…”