Bone marrow concentrate efficacy in treatment of chronic aseptic nonunion

Abstract

<p class="abstract"><strong>Background:</strong> Bone marrow is a rich source of osteoprogenitor cells that proliferate and differentiate into osteoblasts. Traditionally, autologous iliac bone grafts have been used in treatment of nonunion. This technique has its associated morbidity, which include donor site pain, infection, scarring, and nerve injury. The use of percutaneous bone marrow stem cells (BMSC) avoids these morbidities with comparable clinical results.</p><p class="abstract"><strong>Methods:</strong> We studied twenty patients of aseptic nonunion where bone marrow was aspirated from the anterior iliac crest, concentrated on a cell separator, and then injected into the nonunion site under c-arm guidance. Each nonunion received a relatively same amount of concentrated bone marrow. The volume of callus was calculated by dimensions obtained from RISPACS software in our institution.</p><p class="abstract"><strong>Results:</strong> There was an average of 29,418 mm3 of callus formation with a minimum of 4,455 mm<sup>3</sup> and maximum of 68,460. The average time of union was 12 weeks with minimum of 6 weeks and maximum of 24 weeks.</p><p class="abstract"><strong>Conclusions:</strong> The percutaneous bone marrow concentrate injection provides an effective and a safe alternative method for the treatment of a chronic long standing non-union.</p>