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Our first experiences with autologous transplantation of bone marrow stem cells to treat pseudarthrosis, delayed fracture healing and long bone defects fracture


Authors: M. Šír 1;  V. Procházka 2;  J. Gumulec 3;  L. Pleva 1
Authors‘ workplace: Traumatologické centrum FN Ostrava, přednosta doc. MUDr. Leopold Pleva, CSc. 1;  Radiodiagnostický ústav FN Ostrava, přednostka prim. MUDr. Jana Chmelová, Ph. D. 2;  Ústav klinické hematologie FN Ostrava, přednosta prim. MUDr. Jaromír Gumulec 3
Published in: Vnitř Lék 2009; 55(3): 187-189
Category: 15th Parizek's Days

Overview

Traumatology and orthopaedics have undergone substantial progress in the use of new, sophisticated techniques, implants and navigation methods. Nevertheless, these new methods continue to fail in some instances. Regenerative medicine using the growth potential of stem cells that posses the ability to regenerate damaged tissues represent one of the possible ways forward. There is a potential for more comprehensive utilization of bone marrow stem cells that had for many years been used in transplant medicine. Traumatology and orthopaedics could utilise stem cells in the treatment of bone defects, i.e. in the treatment of pseudarthrosis, delayed fracture healing, defect fractures and aseptic bone necroses. Bone formation and growth is a complex, predominantly anabolic, process with a range of feedbacks. Nevertheless, it is the bone marrow where the necessary progenitors of bone growth are located. These are mesenchymal stem cells (MSCs), haema­topoietic stem cells (HSCs) as well as thrombocytes containing a range of necessary growth factors. A number of studies showed positive results for stem cells treatment of pseudarthrosis, with only a fraction, however, being statistically significant in human medicine. This method was used in 11 patients of the Traumatology Centre of the Faculty Hospital in Ostrava, Czech Republic in 2008. The researched patients were treated for pseudarthrosis of long bones, delayed multifragmentary fracture haling and defect fractures of long bones. Autologous concentrate of bone marrow stem cells was applied in one session into the area of bone defect in a patient lightly anaesthetised with propofol. The results from this small sample of patients are not yet available. However, we are sharing our first experiences with this treatment option.

Key words:
regenerative medicine – bone marrow stem cells – pseudoartrosis treatment


Sources

1. Hernigou P, Mathieu G, Poignard Aet al. JBJS Percutaneous Autologous Bone – Marrow Grafting for Nonunions Pountos. J Bone Joint Surg Br 2005; 87: 1430–1437.

2. Jones E, Tzioupis C, McGonagle D et al. Growing bone and cartilage. The Role of Mesenchymal Stem Cells. J Bone Joint Surg Br 2006, 88: 421–426.

3. Simpson AHRW, Mills L, Noble B. The role of growth factors and related agents in accelerating fracture healing. J Bone Joint Surg Br 2006; 88: 701–705.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 3

2009 Issue 3

Most read in this issue
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