Abstract
The purpose of this prospective controlled study was to compare healing quality following the implantation of ultraporous β-tricalcium phosphate, containing either expanded autologous mesenchymal stromal cells (trial group, 9 patients) or β-tricalcium phosphate alone (control group, 9 patients), into femoral defects during revision total hip arthroplasty. Both groups were assessed using the Harris Hip Score, radiography, and DEXA scanning at 6 weeks and 3, 6, and 12 months postoperatively. A significant difference in the bone defect healing was observed between both groups of patients (P < 0.05). In the trial group, trabecular remodeling was found in all nine patients and in the control group, in 1 patient only. Whereas, over the 12-month follow-up period, no significant difference was observed between both groups of patients in terms of the resorption of β-tricalcium phosphate, the significant differences were documented in the presence of radiolucency and bone trabeculation through the defect (P < 0.05). Using autologous mesenchymal stromal cells combined with a β-tricalcium phosphate scaffold is a feasible, safe, and effective approach for management of bone defects with compromised microenvironment. The clinical trial was registered at the EU Clinical Trials Register before patient recruitment has begun (EudraCT number 2012-005599-33).
Highlights
Bone defects subsequent to trauma, tumor resection, infection, and prosthesis loosening pose an important clinical problem
It should be noted that, in order to obtain a total of 9 patients in the trial group, it required a total of participants to be included in this group because bone marrow could not be processed from one patient due to aspirate clotting and it required one repeated aspiration due to aspirate clotting too
The mean Harris Hip Score improved from 51 points to 86 points and the average pain score improved by points to 44 points, postoperatively (Tables 2(a) and 2(b))
Summary
Bone defects subsequent to trauma, tumor resection, infection, and prosthesis loosening pose an important clinical problem. The character of bone defects is classed as either cavitary or segmental. A cavitary defect is a contained lesion and represents an excavation of the cancellous or endosteal cortical bone with no violation of the outer cortical shell. A segmental defect is characterized by the loss of bone in the supporting cortical shell [1]. The ability of bone to regenerate may be compromised by the character, the location, and the size of the bone defect [2]. ConventioSyntax Warning: Could not parse ligature component "0053" of "_0053" in parseCharName
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