The use of percutaneous autologous bone marrow transplantation in nonunion and avascular necrosis of bone

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

doi:10.1302/0301-620x.87b7.16289

Cited by 262 publications

(192 citation statements)

References 61 publications

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“…A triangular-shaped complex of interactions between the potent osteogenic cell populations, the osteoinductive stimulus and the osteoconductive matrix scaffolds are extensively studied and applied in search for the optimal grafting material (Giannoudis et al, 2007;Khan et al, 2011;Virk and Lieberman, 2012). Mechanical stability is added to the diamond model as a crucial factor for bone healing, and essential for the formation of a callus that bridges the fracture site allowing loads to be transmitted across the fracture line (Fayaz et al, 2011;Hernigou et al, 2005b).…”

Section: Discussionmentioning

confidence: 99%

“…The amount of available oxygen is probably one of the most limiting factors after transplantation. Because the transplanted progenitor cells compete with other cells for oxygen, the limitation of the transplanted cells is the best way to optimize progenitor cell survival that contribute to the bone formation (Hernigou et al, 2005b;Pountos et al, 2010). Hernigou et al reported that autologous bone marrow must contain at least 1500 progenitor cells per milliliter in order to be effective for the treatment of nonunion (Hernigou et al, 2005a).…”

Section: Bmac-acb Gramentioning

confidence: 99%

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

et al. 2015

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Abstract-Autologous cancellous bone graft is currently used as a gold standard method for treatment of bone nonunion. However, there is a limit to the amount of autologous cancellous bone that can be harvested and the donor site morbidity presents a major disadvantage to autologous bone grafting. Embedding viable cells within biological scaffolds appears to be extremely promising. The purpose of this study was to assess the outcome of autologous bone marrow stem cells combined with a cancellous bone allograft as compared to an autologous bone graft in the treatment of bone nonunion. Bone marrow aspiration concentrate (BMAC) was previously produced from bone marrow aspirate via a density gradient centrifugation. Autologous cancellous bone was harvested in 9 patients and applied to the nonunion site. In 18 patients of the clinical trial group after the debridement, the bone gaps were filled with a composite of BMAC and allograft cancellous bone chips (BMAC-ACB). Bone consolidation was obtained in 88.9%, and the mean interval between the cell transplantation and union was 4.6 ± 1.5 months in the autograft group. Bone union rate was 94.4% in group of composite BMAC-ACB implantation. The time to union in BMAC-ACB grafting group was 3.3 ± 0.90 months, and led to faster healing when compared to the autograft. A mean concentration of autologous progenitorcells was found to be 2.43 ± 1.03 (x10 6 ) CD34 + cells/ml, and a mean viability of CD34 + cells was 97.97 ± 1.47 (%). This study shows that the implantation of BMAC has presented the efficacy for treatment of nonunion and may contribute an available alternative to autologous cancellous bone graft. But large clinical application of BM-MSCs requires a more appropriate and profound scientific investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Bmac-acb Gramentioning

confidence: 99%

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

et al. 2015

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“…The use of Mesenchymal stem cell (MSC) without an expansion step relies on the separation of sufficient numbers of MSC and concentration of the MSC fraction in a reduced volume that can be injected [9]. Since the MSC cannot easily be identified within the Nuclear Cell (NC) fraction without additional laboratory analysis, the complete NC fraction has to be used, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of bone healing disorders with purified bone marrow is not a new therapy. Attempts at direct bone [3,9].…”

Section: Discussionmentioning

confidence: 99%

Versatility of Pleuripotent Undifferentiated Stem Cells Aspirated from Bone Marrow and its Applications in Oral and Maxillofacial Surgery

Kumar

Mohan

et al. 2015

J. Maxillofac. Oral Surg.

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Introduction Bone marrow (BM) derived pleuripotent undifferentiated stem cells represent a promising population for supporting new concepts in cellular therapy. Aim The aim of this study is to evaluate the versatility of pleuripotent undifferentiated stem cells derived from BM aspiration and its applications in oral and maxillofacial surgical procedures. Materials and Methods A total of 30 patients out of which 15 were with hard tissue defects (cystic lesions n = 6, post surgical alveolar defects n = 4, peri implant defects n = 3, alveolar clefts n = 2) and 15 soft tissue lesions (leukoplakia and lichen planus n = 6, oral submucous fibrosis n = 7, post traumatic soft tissue loss n = 2) were included in the study on randomized clinical basis. The patients received autologous BM derived mononuclear cells which were being locally delivered into the lesion and followed up. The parameters used were (1) To compare and evaluate the bone regeneration by radiographic assessment at the end of 3rd and 6th month postoperatively. Results For hard tissue lesions CT scans and OPG revealed adequate regenerated bone, bridging the defect after 3 months. Hounsfield units of regenerated bone after 6 months were more or less similar to native bone which was statistically significant (unpaired t test = p \ 0.05). For soft tissue lesions (1) 7 cases of OSMF showed adequate clinical mouth opening (one way anova test = p \ 0.05), reduction in burning sensation and blanching of mucosa, (2) 6 cases of leukoplakia and lichen planus and 2 cases of post traumatic soft tissue defects showed good clinical improvement by Vancouver burn scar assessment of wound index. Conclusion The study shows that there is a definite beneficial effect in bone regeneration and soft tissue wound healing with the use of BM-derived mononuclear cells.

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“…Examples of the former include percutaneously injected autologous bone marrow cells without having been expanded in tissue culture. This was tested in the clinical setting for the treatment of tibial non-union (Healey et al, 1990;Hernigou et al, 2005;Goel et al, 2005). However, there are only a low quantity (<0.01%) of available BMSCs in proportion to the total number of cells obtained by bone marrow aspiration.…”

Section: Treatment Of Fracture Non-unionmentioning

confidence: 99%

Updates on stem cells and their applications in regenerative medicine

Bajada

Mazakova

Richardson

et al. 2008

J Tissue Eng Regen Med

303

188

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The use of percutaneous autologous bone marrow transplantation in nonunion and avascular necrosis of bone

Cited by 262 publications

References 61 publications

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

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

Versatility of Pleuripotent Undifferentiated Stem Cells Aspirated from Bone Marrow and its Applications in Oral and Maxillofacial Surgery

Updates on stem cells and their applications in regenerative medicine

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