PURPOSE: Treating segmental long-bone defects remains a major challenge. For defects >3 cm, segmental transport represents the gold standard, even though the method is time consuming and afflicted with several complications. The aim of this study was to evaluate healing of such defects after grafting an osteogenic scaffold previously seeded with stem cell concentrate. METHODS: We evaluated five patients with segmental long-bone defects (3-14 cm) treated with bone marrow aspirate concentrates (BMAC) seeded onto a bovine xenogenous scaffold. The healing process was monitored by X-rays and positron emission tomography-computed tomography (PET-CT) three months after surgery. RESULTS: Centrifugation led to a concentration of leukocytes by factor 8.1 ± 7.5. Full weight bearing was achieved 11.3 ± 5.0 weeks after surgery. PET analysis showed an increased influx of fluoride by factor 8.3 ± 6.4 compared with the contralateral side (p < 0.01). Bone density in the cortical area was 75 ± 16 % of the contralateral side (p < 0.03). The patient with the largest defect sustained an implant failure in the distal femur and finally accomplished therapy by segmental transport. He also had the lowest uptake of fluoride of the patient collective (2.2-fold increase). CONCLUSION: Stem cell concentrates can be an alternative to segmental bone transport. Further studies are needed to compare this method with autologous bone grafting and segmental transport.
PURPOSE: Treating segmental long-bone defects remains a major challenge. For defects >3 cm, segmental transport represents the gold standard, even though the method is time consuming and afflicted with several complications. The aim of this study was to evaluate healing of such defects after grafting an osteogenic scaffold previously seeded with stem cell concentrate. METHODS: We evaluated five patients with segmental long-bone defects (3-14 cm) treated with bone marrow aspirate concentrates (BMAC) seeded onto a bovine xenogenous scaffold. The healing process was monitored by X-rays and positron emission tomography-computed tomography (PET-CT) three months after surgery. RESULTS: Centrifugation led to a concentration of leukocytes by factor 8.1 ± 7.5. Full weight bearing was achieved 11.3 ± 5.0 weeks after surgery. PET analysis showed an increased influx of fluoride by factor 8.3 ± 6.4 compared with the contralateral side (p < 0.01). Bone density in the cortical area was 75 ± 16 % of the contralateral side (p < 0.03). The patient with the largest defect sustained an implant failure in the distal femur and finally accomplished therapy by segmental transport. He also had the lowest uptake of fluoride of the patient collective (2.2-fold increase). CONCLUSION: Stem cell concentrates can be an alternative to segmental bone transport. Further studies are needed to compare this method with autologous bone grafting and segmental transport.
Authors: Johannes C Reichert; Amaia Cipitria; Devakara R Epari; Siamak Saifzadeh; Pushpanjali Krishnakanth; Arne Berner; Maria A Woodruff; Hanna Schell; Manav Mehta; Michael A Schuetz; Georg N Duda; Dietmar W Hutmacher Journal: Sci Transl Med Date: 2012-07-04 Impact factor: 17.956
Authors: Sebastian Sauerbier; Daniela Rickert; Ralf Gutwald; Heiner Nagursky; Toshiyuki Oshima; Samuel P Xavier; Johannes Christmann; Patrick Kurz; Dieter Menne; Arjan Vissink; Gerry Raghoebar; Rainer Schmelzeisen; Wilfried Wagner; Felix P Koch Journal: Tissue Eng Part A Date: 2011-06-24 Impact factor: 3.845
Authors: Loay Al-Zube; Eric A Breitbart; J Patrick O'Connor; J Russell Parsons; Gino Bradica; Charles E Hart; Sheldon S Lin Journal: J Orthop Res Date: 2009-08 Impact factor: 3.494
Authors: Marcus Jäger; Monika Herten; Ulrike Fochtmann; Johannes Fischer; Philippe Hernigou; Christoph Zilkens; Christian Hendrich; Rüdiger Krauspe Journal: J Orthop Res Date: 2010-08-25 Impact factor: 3.494
Authors: Suzanne N Lissenberg-Thunnissen; David J J de Gorter; Cornelis F M Sier; Inger B Schipper Journal: Int Orthop Date: 2011-06-23 Impact factor: 3.075
Authors: Ekaterina M Trifanova; Maria A Khvorostina; Aleksandra O Mariyanats; Anastasia V Sochilina; Maria E Nikolaeva; Evgeny V Khaydukov; Roman A Akasov; Vladimir K Popov Journal: Molecules Date: 2022-10-03 Impact factor: 4.927