Journal ArticleDOI
The effect of autologous concentrated bone-marrow grafting on the healing of femoral shaft non-unions after locked intramedullary nailing
João Antonio Matheus Guimarães,Maria Eugenia Leite Duarte,Marco Bernardo Cury Fernandes,Verônica Fernandes Vianna,Tito Henrique Rocha,Danielle Cabral Bonfim,Priscila Ladeira Casado,Isabel Cristina Chulvis do Val Guimarães,Luis Guillermo Coca Velarde,Hélio S. Dutra,Peter V. Giannoudis,Peter V. Giannoudis +11 more
Reads0
Chats0
TLDR
The efficacy of percutaneous autologous concentrated bone marrow grafting seems to be related to the number of osteoprogenitors available in the aspirates, particularly in patients with failed femoral shaft aseptic non-union.Abstract:
The aim of this study was to assess the union rates in a series of patients with failed femoral shaft aseptic non-union who were treated with percutaneous concentrated autologous bone marrow grafting. Bone marrow harvesting and cell injection were performed under general anaesthesia in a single surgical procedure. Radiographic union was diagnosed in fractures with a score ≥ 10 according to the radiographic union scale in tibial fractures (RUST) and confirmed by clinical examination. Eight out of 16 patients progressed to consolidation (RUST score ≥ 10). Radiographic evidence of fracture union was observed at an average of 4.75 ± 1.75 months (range 3 to 8 months). All eight patients who did not progress to union within 12 months following the cell grafting procedure had a RUST score ≤ 10 (range 4 to 9). There were no differences in age, number of previous surgeries, duration of nonunion and preoperative RUST score between the patients that developed solid union and those with failed consolidation. However, a relationship between the number of osteoprogenitors injected and the rate of union was noted, 20.2 ± 8.6 × 10(8) versus 9.8 ± 4.3 × 10(8), p<0.005, between the patients with and without union, respectively. The efficacy of percutaneous autologous concentrated bone marrow grafting seems to be related to the number of osteoprogenitors available in the aspirates. Optimisation of the aspiration technique and concentration process is of paramount importance to increase the incidence of a successful outcome.read more
Citations
More filters
Journal ArticleDOI
Treatment of atrophic tibia non-unions according to 'diamond concept': Results of one- and two-step treatment
TL;DR: The study showed that the 'diamond concept' is a suitable method for safely and effectively treating non-unions with large defects or infections and the use of an antibiotic-coated nail provides a therapeutic benefit.
Journal ArticleDOI
Long bone non-unions treated with the diamond concept: a case series of 64 patients.
TL;DR: The application of the "diamond concept" in this cohort of patients was associated with a high union rate by providing an optimal mechanical and biological environment and should be considered in the surgeon's armamentarium where difficulty of bone repair is foreseen.
Journal ArticleDOI
The roles of immune cells in bone healing; what we know, do not know and future perspectives
TL;DR: An up to date status of the role of immune cells during the different phases of bone healing is presented and the known and yet to know events about immune cell interactions with MSCs and osteoblasts and osteoclasts and the therapeutic implications are being discussed.
Journal ArticleDOI
The role of peptides in bone healing and regeneration: a systematic review.
Ippokratis Pountos,Michalis Panteli,Anastasios Lampropoulos,Elena Jones,Giorgio Maria Calori,Peter V. Giannoudis,Peter V. Giannoudis +6 more
TL;DR: A significant amount of experimental in vitro and in vivo evidence exists and several peptides were found to upregulate the bone healing response in experimental models and could act as potential candidates for future clinical applications.
Journal ArticleDOI
Shock wave therapy of fracture nonunion.
TL;DR: Using the principles of extracorporeal shock wave therapy in the treatment of nonunion of fractures in 44 patients, union was successful in 75.5% of cases and failure in the remaining cases was due to more than 5mm gap, instability, compromised vascularity and deep low grade infection.
References
More filters
Journal ArticleDOI
Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses
Ramon B. Gustilo,John Anderson +1 more
TL;DR: In 673 open fractures of long bones treated from 1955 to 1968 at Hennepin County Medical Center, Minneapolis, Minnesota, and analyzed retrospectively and in a prospective study from 1969 to 1973, Sensitivity studies suggested that cephalosporin is currently the prophylactic antibiotic of choice.
Journal ArticleDOI
Fracture and dislocation classification compendium - 2007: Orthopaedic Trauma Association classification, database and outcomes committee.
J. L. Marsh,Theddy Slongo,Julie Agel,J. Scott Broderick,William Creevey,Thomas A. DeCoster,Laura Prokuski,Michael S. Sirkin,Bruce H Ziran,Brad Henley,Laurent Audigé +10 more
TL;DR: The OTA classification was originally published in a compendium of the Journal of Orthopaedic Trauma in 1996 and was significantly revised for the clavicle and scapula, foot and hand, and patella.
Journal ArticleDOI
Osteogenic protein-1 (bone morphogenetic protein-7) in the treatment of tibial nonunions.
Gary E. Friedlaender,C. R. Perry,J. D. Cole,S. D. Cook,G. Cierny,G. F. Muschler,G. A. Zych,J. H. Calhoun,A. J. LaForte,S. Yin +9 more
TL;DR: In this paper, the role of bone morphogenetic proteins (BMPs) in osseous repair has been demonstrated in numerous animal models and a clinical trial conducted under a FDA approved Investigational Device Exemption to establish both the safety and efficacy of this BMP in the treatment of tibial nonunions.