PURPOSE: The reason for the formation of an atrophic non-union is not clear and an altered vascularization as well as a deregulation of endogenous growth factors is hypothesized. To obtain more information, we analysed human non-union tissue regarding the histology and quantity of several growth factors. METHODS: Tissue from patients with an atrophic non-union (n = 44) or with a healed fracture (n = 13) was analysed. Using histological and immunohistochemical methods the tissue composition was investigated. On the protein level the amount of several growth factors important for bone healing was analysed. RESULTS: The tissue composition was very inhomogeneous containing fibrous, cartilaginous and bony tissue. Vessels were present in all investigated samples without a difference between the tissue from non-union and control patients. The growth factor BMP-2 was below the detection limit in all samples, whereas IL-6 and IGF-I were measured only in a few samples of both groups. TGF-ß1, VEGF-A and BMP-4 were detectable in the majority of the samples of both groups with a high variability in the amount but no difference between the groups. The quantity of both growth factors, BMP-7 and PDGF-AB, was significantly lower in the non-union tissue compared to the healed controls. CONCLUSION: The reduced quantity of BMP-7 and PDGF-AB might be responsible for the impaired healing. Further studies analysing material from more patients and investigating the early healing phases, however, are necessary to obtain further information and consequently improve healing strategies.
PURPOSE: The reason for the formation of an atrophic non-union is not clear and an altered vascularization as well as a deregulation of endogenous growth factors is hypothesized. To obtain more information, we analysed human non-union tissue regarding the histology and quantity of several growth factors. METHODS: Tissue from patients with an atrophic non-union (n = 44) or with a healed fracture (n = 13) was analysed. Using histological and immunohistochemical methods the tissue composition was investigated. On the protein level the amount of several growth factors important for bone healing was analysed. RESULTS: The tissue composition was very inhomogeneous containing fibrous, cartilaginous and bony tissue. Vessels were present in all investigated samples without a difference between the tissue from non-union and control patients. The growth factor BMP-2 was below the detection limit in all samples, whereas IL-6 and IGF-I were measured only in a few samples of both groups. TGF-ß1, VEGF-A and BMP-4 were detectable in the majority of the samples of both groups with a high variability in the amount but no difference between the groups. The quantity of both growth factors, BMP-7 and PDGF-AB, was significantly lower in the non-union tissue compared to the healed controls. CONCLUSION: The reduced quantity of BMP-7 and PDGF-AB might be responsible for the impaired healing. Further studies analysing material from more patients and investigating the early healing phases, however, are necessary to obtain further information and consequently improve healing strategies.
Authors: T Kon; T J Cho; T Aizawa; M Yamazaki; N Nooh; D Graves; L C Gerstenfeld; T A Einhorn Journal: J Bone Miner Res Date: 2001-06 Impact factor: 6.741
Authors: Peter Kloen; Steven B Doty; Eric Gordon; Iván F Rubel; Marie-José Goumans; David L Helfet Journal: J Bone Joint Surg Am Date: 2002-11 Impact factor: 5.284
Authors: Brent D Bates; Charles Godbout; David J Ramnaraign; Emil H Schemitsch; Aaron Nauth Journal: Stem Cells Int Date: 2017-03-30 Impact factor: 5.443
Authors: Christian Fischer; Christian Reiner; Gerhard Schmidmaier; Julian Doll; Christopher Child; Paul Alfred Grützner; Bahram Biglari; Sonja Boxriker; Arash Moghaddam Journal: Ther Clin Risk Manag Date: 2018-04-16 Impact factor: 2.423
Authors: Frederico C Vallim; João Antonio Matheus Guimarães; Rhayra B Dias; Rafaela C Sartore; Amanda Dos S Cavalcanti; Ana C Leal; Maria Eugenia L Duarte; Danielle C Bonfim Journal: OTA Int Date: 2018-12-18
Authors: Michalis Panteli; James S H Vun; Ippokratis Pountos; Anthony J Howard; Elena Jones; Peter V Giannoudis Journal: J Cell Mol Med Date: 2022-01-04 Impact factor: 5.310
Authors: Doron Cohn-Schwartz; Yeshai Schary; Eran Yalon; Zoe Krut; Xiaoyu Da; Edward M Schwarz; Dan Gazit; Gadi Pelled; Zulma Gazit Journal: Cells Date: 2022-03-05 Impact factor: 6.600
Authors: Lars Helbig; Georg W Omlor; Adriana Ivanova; Thorsten Guehring; Robert Sonntag; J Philippe Kretzer; Susann Minkwitz; Britt Wildemann; Gerhard Schmidmaier Journal: BMC Musculoskelet Disord Date: 2018-07-27 Impact factor: 2.362