Nonunions and the Potential of Stem Cells in Fracture-Healing

Tseng, Susan; Lee, Mark A.; Reddi, A. Hari

doi:10.2106/jbjs.g.01192

Cited by 121 publications

(99 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A reduced pool of human bone marrow stromal/stem cells (BMSCs) correlates with altered bone repair in patients with fracture nonunions (5,6). The administration of BMSCs has shown promise in treating patients with fracture nonunions in some settings (7)(8)(9)(10)(11)(12). Interestingly, recent studies using reporter-tagged BMSCs have demonstrated that transplanted BMSCs specifically localize within the fracture gap and intramedullary or internal calluses rather than within the external callus tissues mostly derived from the periosteum and surrounding soft tissue, suggesting a localized and specific role for BMSCs in fracture repair (13,14).…”

Section: Introductionmentioning

confidence: 99%

NOTCH signaling in skeletal progenitors is critical for fracture repair

Wang¹,

Inzana²,

Mirando³

et al. 2016

Journal of Clinical Investigation

107

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

NOTCH signaling in skeletal progenitors is critical for fracture repair

Wang¹,

Inzana²,

Mirando³

et al. 2016

Journal of Clinical Investigation

107

View full text Add to dashboard Cite

“…On the other hand, autologous bone marrow injection enhances cellular numbers and stimulates the cells to fabricate a structural osteoconductive substrate with extremely low donor site morbidity (Pountos, 2010). Bone marrow injection is a mini-invasive technique and can contribute to bone union in cases of stable delayed or nonunion (Bhutia, 2015;Singh, 2013;Tseng, 2008). It has reduced soft tissue damage, improved the recovery period, and minimized scaring.…”

Section: Discussionmentioning

confidence: 99%

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

Thua¹,

Pham²,

Le³

et al. 2015

Biomed Res Ther

View full text Add to dashboard Cite

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.

show abstract

“…However, there are traumatic situations in which bone fails to regenerate itself leading to non-union [22] . While there is no universally accepted definition, non-union refers to a fracture that has not united within 6 to 9 months after fracture onset and that requires additional surgical or non-surgical intervention.…”

Section: Rationale Of Cell Therapy For Fracture Repairmentioning

confidence: 99%

Cell therapy for bone fracture repair: A comparative preclinical review of mesenchymal stromal cells from bone marrow and from adipose tissue

et al. 2015

View full text Add to dashboard Cite

Abstract:Over the last decade, there has been an increasing interest among researchers for human mesenchymal stromal cells (MSC). Their regenerative properties, multilineage differentiation capacity and immunomodulatory properties make them promising candidates for treatment in various conditions. Emerging biotechnology companies specialized in cellular and regenerative therapies have been focusing their interest on MSC-based therapies, and their use in clinical trials has steadily increased. Notably, MSC are currently tested in clinical trials addressing unmet medical needs in the field of bone fracture repair and more specifically in non-union and delayed union fractures where the bone repair process is impaired. Although MSC can be isolated from various tissues, the most commonly studied sources are bone marrow (BM) and adipose tissue (Ad). In this article, we reviewed the literature directly comparing BM-and Ad-MSC for their in vitro characteristics and in vivo osteogenic potential to determine which source of MSC would be more appropriate for bone fracture repair. As considerable variations in experimental settings between studies were found, our review was based on studies meeting specific sets of criteria, notably regarding donors' age and gender. This review of side-by-side comparisons suggests that while BM-and Ad-MSC share common general characteristics, BM-MSC have a higher intrinsic osteogenic capacity in vitro and bone repair potential in vivo. Keywords: adipose tissue-derived mesenchymal stromal cells, bone marrow-derived mesenchymal stromal cells, MSC, proliferation, yield, immunophenotype, osteogenic differentiation, in vivo, preclinical, regenerative medicine, cell therapy, human, review *Correspondence to: Enrico Bastianelli, Bone Therapeutics S.A., PWTC, 37 rue Auguste Piccard, 6041 Gosselies, Belgium; Email: enrico.bastianelli@bonetherapeutics.com All authors contributed equally to this work.

show abstract

Nonunions and the Potential of Stem Cells in Fracture-Healing

Cited by 121 publications

References 55 publications

NOTCH signaling in skeletal progenitors is critical for fracture repair

NOTCH signaling in skeletal progenitors is critical for fracture repair

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

Cell therapy for bone fracture repair: A comparative preclinical review of mesenchymal stromal cells from bone marrow and from adipose tissue

Contact Info

Product

Resources

About