Sometimes a broken bone fail to heal (“nonunion”) and it is necessary to induce the formation of new bone tissue to connect the broken pieces.

Investigators from the Instituto Venezolano de Investigaciones Cientificas (IVIC) and orthopedic surgeons from the Hospital Universitario de Caracas have developed a new treatment for these complicated bone fractures. Their method makes use of the ability of mesenchymal stem cells, isolated from the bone marrow, to induce the formation of new bone. Their method utilizes stem cells isolated from patient’s own bone marrow, thus there is no rejection.

Fig. 1.

In cell cultures in the laboratory, mesenchymal stem cells, are isolated from the patient own bone marrow, multiplied to many millions and differentiated, in specific cell cultures, partly into bone forming cells (“osteogenic progenitors”) and partly into blood vessels forming cells (“endothelial progenitor”). An important step for this work was the finding that these cells could grow in cell cultures adherent to the surface of microspheres of collagen, allowing their use as carriers for the stem cells.

For the treatment of the patients with nonunion, many millions of collagen microspheres, laden with adherent osteogenic and endothelial progenitor stem cells, are prepared in the laboratory and brought to the operating room. To make easier the placement of the stem cells in the nonunion gap fracture, when the patient is already prepared to receive the transplant, the stem cells, were included in clots made from the patient’s own blood plasma rich platelet. Then, the clots, containing the collagen microspheres laden with stem cells, were placed in the fracture gap and covered with a collagen matrix to keep them in place.

Initially, three patients with a long history of impaired fracture healing were treated. In all patients, after three months post transplantation of the stem cells, there was evidence of formation of new bone in the site of nonunion and complete healing of the nonunion after a year.

As in illustration, in the figure it can be seen the nonunion in the tibia (arrows) and peroneal bones (arrow and triangle) before treatment. One year after treatment, a complete heal of the tibia and lower peroneal nonunion can be seen. The upper peroneal nonunion (triangle), not treated, did not heal. A trial, with more patients is going on.

Egidio Romano, Jose Cardier

Publication

A method of treatment for nonunion after fractures using mesenchymal stromal cells loaded on collagen microspheres and incorporated into platelet-rich plasma clots.
Wittig O, Romano E, González C, Diaz-Solano D, Marquez ME, Tovar P, Aoun R, Cardier JE.
Int Orthop. 2016 May

Read offline:

Related Articles:

	The roles of mesenchymal stem cells secretome in diabetic…There has been a fourfold rise in the number of diabetics from 108 million in 1980 to 422 million in 2014 and by 2040 the number will reach to 642…
	间充质干细胞治疗膝骨的arthritisCartilage in the knee does not heal very well nor very quickly, so continued use of the leg when walking for example can result in further damage, bony projections (osteophytes),…
	Medical grade honey facilitates the healing of minor…Children are at risk to injuries and wounds as it is their nature to play and explore in adventurous environments. At the same time, they are less experienced in calculating…
	L-Mesitran Medical Grade Honey works better for treating…In a recent clinical study, it was shown that L-Mesitran improves the healing time of cold sores in relation to conventional treatments. In addition, pain and itching were decreased. Cold…
	A new procedure to accurately define Nitrate Vulnerable…The Nitrates Directive of the European Union (91/676/EEC) aims to reduce and prevent water pollution caused by nitrates from agricultural sources. It establishes that water resources should be considered polluted…
	What treatment is really medically and economically…Currently, direct-acting agent (DAA) therapies have high efficacy and safety and are the main strategy to eliminate hepatitis C virus (HCV) worldwide. Some DAA therapies are also effective for HCV-infected…