Validation of a long bone fracture non-union healing score after treatment with mesenchymal stromal cells combined to biomaterials

Abstract

The available scores to clinically evaluate fracture consolidation encounter difficulties to interpret progression towards consolidation in long-bone non-union, particularly when incorporating biomaterials in the surgical treatment. The aims of this study were to validate the REBORNE bone healing scale in tibia, humerus and femur non-unions treated by a combination of mesenchymal stromal cells (MSCs) and biomaterials, through the interclass correlation (ICC) among raters, and to define reliability and concordance in anteroposterior and lateral radiographs, compared to computed tomography (CT). Methods: Twenty-six cases from the EudraCT 2011-005441-13 clinical trial underwent bone healing evaluation, if at least 3 out of 4 cortical views clearly identified. Three senior orthopaedic surgeons evaluated radiographs and CTs at 3 and 6 months FU. All cases included preoperative imaging and radiographs at 12 months. The 4-stage scale score was obtained from each cortical view in orthogonal radiographs or CTs. A score of 0.6875 (11/16) was set as a threshold for bone healing. Statistically, ICC evaluated agreement among raters. Cronbach's alpha coefficient tested reliability. Lin's concordance correlation coefficients (CCC) were estimated between mean CT scores and mean radiographic scores. Bland and Altman graphs provided the limits of agreement between both imaging techniques. Sensitivity and specificity were assessed in radiographs (against CT), and the Area Under the Receiver Operating Characteristics

Clinical Application of Bone Marrow Mesenchymal Stem/Stromal Cells to Repair Skeletal Tissue

“…Whilst there are challenges associated with the generation of diverse tissue engineering strategies, considerable advances have been made to repair and regenerate skeletal tissue using numerous approaches, which are continuing to be developed and improved with particular attention given to elucidating the mechanisms by which regeneration is facilitated [35][36][37][38]. These include choosing the right source of the stem cell, whether autologous or allogeneic; how these stem cells are localized to the injury site directly or indirectly through migration; and whether endogenous BMSC are recruited to participate in the regeneration process [39,40].…”

Functional assessment of long bone fracture healing in Samburu County Referral Hospital (Kenya): the squat and smile challenge

“…To evaluate the BH process, we adopted the REBORNE bone healing score that was defined to perform a detailed evaluation of long bone nonunion consolidation in radiographs. [ 21 ]…”

Long non-coding RNA MIR22HG inhibits the adipogenesis of human bone marrow mesenchymal stem cells with the involvement of Wnt/β-catenin pathway

“…As a chemical compound, it was proved to influence autophagy differently in various cell lines (Shou et al, 2020;Sun et al, 2021;Wang et al, 2018). NTZ also significantly inhibited proliferation and promoted apoptosis in cardiomyocytes (Gong et al, 2021). Although effects of NTZ on BMSCs stay unidentified, it is possible that NTZ can influence many aspects of BMSCs such as proliferation, autophagy, and apoptosis.…”