Percutaneous autologous bone marrow injection for treatment of delayed and non-union of long bone: A retrospective study of 45 cases

Issue title: Selected Papers from the 5th China–France International Symposium “Stem Cells: From Bench to Bedside”, 12–14 December 2013, Kunming, China

Article type: Research Article

Authors: Gross, Jean-Baptiste^; | Diligent, Jérôme^; | Bensoussan, Danièle^{; ;} | Galois, Laurent^; | Stoltz, Jean-François^{; ;} | Mainard, Didier^{; ; ;}

Affiliations: Service de Chirurgie Orthopédique et Traumatologique, Hôpital Central, Nancy, France | CNRS, UMR 7365, Biopole, Faculté de Médecine, Vandœuvre-lès-Nancy, France | CHU de Nancy, Unité de Thérapie Cellulaire et Tissulaire (UTCT) (FR CNRS-INSERM-UHP-CHU 3209), Hôpitaux de Brabois, Vandœuvre-lès-Nancy, France | Université de Lorraine, Nancy, France

Note: [] Address for correspondence: Didier Mainard, Service de Chirurgie Orthopédique et Traumatologique, Hôpital Central, 29 avenue de Lattre de Tassigny, 54000 Nancy, France. E-mail: didier.mainard@univ-lorraine.fr

Abstract: BACKGROUND: Non-union of long bones is still a current problem in traumatology. Although corticocancellous bone autograft remains the usual procedure for the treatment of non-union, innovative therapies such as, percutaneous autologous concentrated bone marrow grafting (PABMG), are now appearing. MATERIAL AND METHODS: Over a period of 8 years, 45 non-union of long bones were treated by PABMG in the Department of Orthopaedic and Traumatologic Surgery (University Hospital of Nancy, France): 26 tibiae, 16 femurs, 3 humeri. Efficiency was evaluated by clinical criteria: full weight-bearing without pain, absence of motion at non-union site, and radiological criteria: healing of 3 corticales out of 4. RESULTS: Eighteen out of 28 non-unions at the tibia were healed (69%), 10 at the femur (63%), but none was noticed at the humerus. Some pejorative prognosis factors were noted such as: tobacco, alcohol abuse, diabetes and history of infection at the fracture site. An earlier grafting improved the success rate. The number of CFU-F (Colony Forming Unit Fibroblastic) affected the healing time more than the healing rate. CONCLUSION: The procedure, even though a little invasive, enables the healing of non-union in two out of three cases with less morbidity than conventional procedures. This procedure fits perfectly into the therapeutic arsenal of non-union.

Keywords: Non-union, mesenchymal stem cells, bone marrow grafting, bone marrow, bone healing, cell therapy

DOI: 10.3233/BME-141235

Journal: Bio-Medical Materials and Engineering, vol. 25, no. s1, pp. 187-197, 2015