Injection Of Autologous Bone Marrow Research Articles

Autologous concentrated bone marrow injection for precollapse osteonecrosis of the femoral head concurrent with contralateral total hip arthroplasty: protocol for a clinical trial

IntroductionThe femoral head contralateral to the collapsed femoral head requiring total hip arthroplasty (THA) often manifests in the precollapse stage of osteonecrosis of the femoral head (ONFH). It is not...

Femoral nailing associated with bone marrow emboli in pigs induced a specific increase in blood IL-6 and broad inflammatory responses in the heart and lungs.

Bone marrow embolization may complicate orthopedic surgery, potentially causing fat embolism syndrome. The inflammatory potential of bone marrow emboli is unclear. We aimed to investigate the inflammatory response to femoral intramedullary nailing, specifically the systemic inflammatory effects in plasma, and local tissue responses. Additionally, the plasma response was compared to that following intravenous injection of autologous bone marrow. Twelve pigs underwent femoral nailing (previously shown to have fat emboli in lung and heart), four received intravenous bone marrow, and four served as sham controls. Blood samples were collected hourly and tissue samples postmortem. Additionally, we incubated bone marrow and blood, separately and in combination, from six pigs in vitro. Complement activation was detected by C3a and the terminal C5b-9 complement complex (TCC), and the cytokines TNF, IL-1β, IL-6 and IL-10 as well as the thrombin-antithrombin complexes (TAT) were all measured using enzyme-immunoassays. After nailing, plasma IL-6 rose 21-fold, compared to a 4-fold rise in sham (p=0.0004). No plasma differences in the rest of the inflammatory markers were noted across groups. However, nailing yielded 2-3-times higher C3a, TCC, TNF, IL-1β and IL-10 in lung tissue compared to sham (p<0.0001-0.03). Similarly, heart tissue exhibited 2-times higher TCC and IL-1β compared to sham (p<0.0001-0.03). Intravenous bone marrow yielded 8-times higher TAT than sham at 30 minutes (p<0.0001). In vitro, incubation of bone marrow for four hours resulted in 95-times higher IL-6 compared to whole blood (p=0.03). A selective increase in plasma IL-6 was observed following femoral nailing, whereas lung and heart tissues revealed a broad local inflammatory response not reflected systemically. In vitro experiments may imply bone marrow to be the primary IL-6 source.

Assessing the efficacy and safety of autologous bone marrow injections in treating delayed union of long bone fractures: A retrospective analysis

Background: Delayed union in long bone fractures poses a significant clinical challenge, necessitating effective treatment solutions. The urgency for novel and effective treatment modalities is ever-increasing, especially considering the prevalence and complications associated with delayed union. Aims and Objectives: This retrospective analysis aims to assess the safety and efficacy of autologous bone marrow injections in treating delayed union in a diverse cohort of individuals with long bone fractures. Materials and Methods: The study includes 100 individuals aged 21–69 with varying fracture types. Fracture classifications comprised 40% closed fractures (n=40) and 60% open fractures (n=60). Notably, the femur had a higher prevalence of open fractures (n=30) than closed fractures (n=20). Tibia fractures demonstrated a similar propensity, with 25 open and 15 closed cases. Humerus fractures manifested an even distribution between open and closed categories (n=5 each), indicating their relative resilience to open fractures. Results: Union was attained in 82 cases, with a mean union time of 7.4 weeks post-the-third bone marrow injection. The timeframe for the union varied widely, ranging from 4 to 17 weeks. In eight instances where bone marrow injections failed to achieve union, alternative treatment via bone grafting was necessary. No significant complications were reported; however, minor discomfort was experienced by 13% of the patients and was effectively managed with over-the-counter analgesics. Conclusion: This retrospective analysis demonstrates the high efficacy and safety of autologous bone marrow injections in treating delayed union in long bones, making them a promising alternative treatment strategy with minimal complications.

A STUDY OF MANAGEMENT OF NON UNION BONES BY AUTOLOGUS BONE MARROW INJECTION.

Background : Non union is a serious complication of fracture and has multiple causes of which most common cause is lack of osteoconductive mediators, osteogenic cells and adequate vascularity. As most of the nonunion fractures are treated by open bone graft. we conducted a study on 30 patients with non union fracture treated by autologous bone marrow injection. As autologous bone marrow injections containing mesenchymal stem cells (MSC) increases the osteogenic potential of these non-union sites and can obtain healing of these non-union site. Material and Methods: A total 50 patients with non-union,33 were male and 17 were female,15 were femur nonunion,21 were tibia nonunion,6 were humerus nonunion, 5 were radius nonunion, 3 were ulna nonunion. Study conducted on these patients and were treated with autologous bone marrow injection at the fracture site under regional anaesthesia in supine position. patients were evaluated at pre operative and post operative follow up period with serial radiography at 6 weeks,12 weeks, 6 months and 9 months. average duration of treatment was 9months and outcome was evaluated with ASAMI scoring system. Union occurred in 82% patients. out of 50, 31 (64%) patients outc Results: ome was excellent, followed by 5 (10%) had good outcome, 5 (10%) had fair and 9(18%) had poor long bone and functional outcomes. Manageme Conclusion: nt of nonunion bones by autologous bone marrow injection provides an effective and reliable alternative to open bone grafting. Thus,it is observed that with an adequate amount of autologous bone marrow injection, union can be achieved in non union of bones

Endoscopic ultrasound-guided intraportal injection of autologous bone marrow in patients with decompensated liver cirrhosis: A case series

Endoscopic ultrasound-guided intraportal injection of autologous bone marrow in patients with decompensated liver cirrhosis: A case series

Percutaneous autologous bone marrow concentrate for knee osteoarthritis: patient-reported outcomes and progenitor cell content

PurposeKnee osteoarthritis (OA) is a common, progressively debilitating joint disease, and the intra-articular injection of autologous bone marrow concentrate (BMC) may offer a minimally invasive method of harnessing the body’s own connective tissue progenitor cells to counteract accompanying degenerative effects of the disease. However, the extent to which the progenitor cell content of BMC influences treatment outcomes is unclear. We sought to determine whether patient-reported outcome measures associated with BMC treatment for knee OA are related to the concentration of progenitor cells provided.MethodsIn the present study, 65 patients (72 knees) underwent treatment for knee OA with autologous BMC and self-reported their outcomes for up to one year using follow-up questionnaires tracking function, pain, and percent improvement. A small fraction of each patient’s BMC sample was reserved for quantification with a haematological analyzer and cryopreserved for subsequent analysis of potential connective tissue progenitor cells using a colony-forming unit fibroblast (CFU-F) assay.ResultsPatients reported significant increases in function and overall percent improvement in addition to decreases in pain relative to baseline levels following treatment with autologous BMC that persisted through 12 months. Patients reporting improved outcomes (46 of 72 knees) received BMC injections having higher CFU-F concentrations than non-responding patients (21.1×103 ± 12.4×103 vs 14.3×103 ± 7.0 x103 CFU-F per mL). A progenitor cell concentration of 18×103 CFU-F per mL of BMC was found to best differentiate responders from non-responders.ConclusionThis study provides supportive evidence for using autologous BMC in the minimally invasive treatment of knee OA and suggests that increased progenitor cell content leads to improved treatment outcomes.Trial registrationClinicalTrials.gov Identifier: NCT03011398, 1/7/17

Percutaneous autologous bone marrow injection in the treatment of delayed union of long bone fractures after definitive fixation

The purpose of this study was to assess the results of percutaneous autologous bone marrow injection in the treatment of delayed union of long bone fractures after definitive fixation. It has been a gruelling job for the orthopaedic surgeons to deal with the delayed union after definitive fixation due to the lack of patient compliance for reoperation like classical bone grafting technique for delayed union and non-union, unfavourable fracture site morphology for external compression, post-operative surgical wound issues etc., The percutaneous autologous bone marrow injection is a reasonable choice in this scenario for the treatment of Delayed union of long bone fractures after definitive fixation. The study was performed in the department of orthopaedics Assam Medical College and Hospital, Dibrugarh, Assam, India for a period of 2 years from July 2019 to June 2021. A total of 23 patients were taken with delayed union of long bone fractures after definitive fixation. These 23 patients were treated with percutaneous autologous bone marrow injection and followed up for 6 months. The results were evaluated on the basis of clinico-radiological criteria of union, and found to be excellent in 60.86% (14/23), good in 17.39% (4/23) and poor in 21.73% (5/23) cases. The percutaneous autologous bone marrow injection provides cellular stimulation and promotes fracture healing without the necessity for opening the fracture site. Hence it is an effective method to bring about successful outcome of delayed union of long bone fractures after definitive fixation without adding any significant complication to the patient and the fracture site.

Сравнительный анализ результатов хирургического лечения несросшихся переломов и ложных суставов костей предплечья

Objective To compare outcomes of non-union in forearm fractures treated with the use of a comprehensive surgical approach considering the injury pattern and localization. Material and methods Based on treatment approaches the cases were categorized into 3 groups with proximal forearm fractures (group I, n = 28; 33.8 %), mid-shaft and distal forearm fractures (group II, n = 32; 38.5 %), and controls (group III, n = 23; 27.7 %). Group I included patients with hypertrophic nonunion (HTNU) of the forearm bones treated with bone graft and plating. Group II consisted of atrophic nonunion, HTNU of the forearm bones repaired with the Ilizarov external fixation. A single 3 mL local injection of autologous bone marrow and a kukumazim solution of 50 PU were used to induce bone fusion in the patients of the two groups. The control group included non-unions with no considerations to the fracture pattern and localization. All patients underwent physical, radiological examinations and laboratory tests. Results The control group showed 8.7 % poor and 69.5 % good outcomes at a long term, whereas 3.6 % results were rated as poor and 82.1 % as good in group I, with 3.1 % poor and 87.6 % good outcomes in group II. The ratings can be associated with a differentiated surgical approach considering the injury pattern and localization, the use of kukumazim proteolytic enzymes and autologous bone marrow injection. Conclusion Optimization of surgical treatments and considerations for injury pattern and localization allowed for a 2.8-time (3.1 %) decrease in poor outcomes and a 30 % reduction in the limb immobilization period.

Comparison of three treatment methods for simple bone cyst in children

BackgroundThe unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children.MethodsEighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods.ResultsAll cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other).ConclusionsThe method of ABM combined with ESIN for children’s bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.

Analysis of curative effect of percutaneous autologous bone marrow cell transplantation for treating nonunion under laser positioning and navigation guidance

Fracture end cleaning, local bone grafting, and fixation are the classic treatment methods for fracture nonunion, but patients normally need to wait for a long time to ensure that there are signs of further healing. The purpose of this research is to verify whether precision injection improvement can be developed as treatment associated with autologous bone marrow cell injection to promoting fracture healing. The curative effect of traditional autologous bone marrow injection for the treatment of poor fracture healing is affected by injection accuracy and locally available cell retention the clinical. The curative effect of autologous bone marrow injection can be effectively improved through autologous bone marrow centrifugation and bone grinding at fracture end when combined with preoperative three-dimensional computed tomography (CT) planning. This minimally invasive treatment method is especially suitable for patients with delayed fracture healing within six months of presentation. Patients with nonunion over six months can be treated with improved autologous bone marrow injection. The convenient and minimally invasive method itself will not be difficult for patients, physically and mentally, and the most reliable treatment method for nonunion is to cut and clean hardened bone and implant autologous bone fixation.

Observation on role of bone marrow aspirate in the delayed union and non union of long bones

Background: Cells aspirated from bone marrow have been shown to provide stimulus for osteogenesis in animal experiments and in clinical evaluation of bone graft and bone substitutes. Despite this osteogenic characteristic, the clinical use of marrow as an osteogenic source has remained limited. The marrow is harvested by means of needle aspiration from the patient's pelvic bone and is then injected percutaneously at the nonunion site. This method offers the advantage of treating fracture-healing problems without operative exposure of either the donor or the recipient site.Aim: The purpose of this study was to ascertain the osteogenic potential of autologous bone marrow injection and its effectiveness in the management of delayed union and nonunion.Material and Methods: Autologous marrow injection was used to stimulate healing in 26 out of 34 patients were males. patients with delayed union and nonunion of fracture of the long bones This prospective study was done in Orthopaedic department of Darbhanga Medical College and Hospital in Laheriasarai, Darbhanga over a period of 2 years (2018 – 2020).Surgical Technique: Bone marrow aspirated from the iliac crest was injected at the fracture site.Results: Marrow stimulated callus formation sufficient to unite in delayed unions and nonunions immobilized with cast or intramedullary nails.Conclusion: Bone marrow injection was as effective as open autogenous grafting but with considerably less complications. Thus, the technique provides a reliable source of osteogenic stem cells with numerous advantages compared with standard open grafting techniques.

Early injection of autologous bone marrow concentrates decreases infection risk and improves healing of acute severe open tibial fractures

IntroductionOpen fractures are at risk of nonunion; surgeons are reluctant to propose early standard bone grafting after open fractures, preferring to wait in order to adequately assess the facture status of infection. Bone marrow contains mesenchymal stem cells (MSCs) and granulocyte and macrophage precursors identified in vitro as colony forming units-granulocyte macrophage (CFU-GM), both of which have a prophylactic action against infection. We therefore tested the hypothesis that early injection of bone marrow concentrate would be useful in these fractures. MethodsWe evaluated a series of 231 patients who had received early percutaneous implantation of bone marrow concentrate (BMC) to treat open fractures (with gap less than 10 mm) that were Gustilo-Anderson Type II or III. The results were compared with those of 67 control (no early graft) patients and with those of 76 patients treated with an early, standard of care, iliac bone graft. All patients were treated with external fixation and were considered to have an aseptic fracture at the time of early grafting, but the actual status of infection was re-assessed at the time of grafting by histology and/or analysis of the aspirate. The bone marrow graft contained after concentration 49,758 ± 21,642 CFU-GM-derived colonies/cc and 9400 ± 1435 MSCs/cc which represents an important increase compared to the level of CFU-GM cells and MSCs present in a standard auto-graft. Healing was evaluated at 9 months. ResultsThe rate of unsuspected infections was higher than 15% in the 3 groups. Bone union and removal of external fixation was achieved at 9 months by 50.7% of patients in the Control Group, by 86.8% of patients in the group with a standard bone graft, and by 87.4% of patients in the bone marrow group. A 90% risk reduction (p = 0.005) in the need for an invasive standard bone graft to treat a nonunion and in the risk of infection was observed when bone marrow was proposed as early injection to the treatment of type II or type-III tibial fractures. ConclusionBone marrow concentrate for early grafting in open fractures with limited gap was efficient for healing while decreasing infection.

Effectiveness of percutaneous injection of autologous concentrated bone marrow aspirate combined with platelet-rich plasma in treatment of delayed fracture healing

To analyze the effectiveness of percutaneous injection of autologous concentrated bone marrow aspirate (cBMA) combined with platelet-rich plasma (PRP) in the treatment of delayed fracture healing. A prospective, randomized, controlled, single-blind case study was conducted. Between March 2016 and July 2018, 66 patients who met the inclusion and exclusion criteria for delayed fracture healing but had solid internal fixation of the fracture end were randomly divided into control group (31 cases, treated with percutaneous autogenous bone marrow blood injection) and study group (35 cases, treated with percutaneous autogenous cBMA+PRP injection). General data such as gender, age, body mass index, site of delayed fracture healing, length of bone defect at fracture end, and preoperative radiographic union score for tibia (RUST) showed no significant difference between the two groups ( P>0.05). Before injection, Kirschner wire was used in both groups to stimulate the fracture end and cause minor injury. The fracture healing time, treatment cost, and adverse reactions were recorded and compared between the two groups. Visual analogue scale (VAS) score was used to evaluate pain improvement. The tibial RUST score was extended to the tubular bone healing evaluation. No infection of bone marrow puncture needle eyes occurred in both groups. In the control group, local swelling was obvious in 5 cases and pain was aggravated at 1 day after operation in 11 cases. In the study group, postoperative swelling and pain were not obvious, but 2 cases presented local swelling and pain. All of them relieved after symptomatic treatment. Patients in both groups were followed up, the follow-up time of the control group was 16-36 months (mean, 21.8 months), and the study group lasted 14-33 months (mean, 23.2 months). The amount of bone marrow blood was significantly lower in the study group than in the control group ( t=4.610, P=0.000). The degree of postoperative pain in the study group was less than that in the control group, and the treatment cost was higher than that in the control group. But the differences between the two groups in VAS score at 1 day after operation and treatment cost were not significant ( P>0.05). Fracture healing was achieved in 19 cases (61.3%) in the control group and 30 cases (85.7%) in the study group. The difference in fracture healing rate between the two groups was significant ( χ 2=5.128, P=0.024). Fracture healing time and RUST score at last follow-up were significantly better in the study group than in the control group ( P<0.05). At last follow-up, RUST scores in both groups were significantly improved when compared with those before operation ( P<0.05). Autogenous cBMA combined with PRP percutaneous injection can provide high concentration of BMSCs and growth factors, and can improve the fracture healing rate and shorten the fracture healing time better than autogenous bone marrow blood injection.

A COMPARATIVE STUDY OF IN VIVO EFFECT OF PERCUTANEOUS BONE MARROW INJECTION VS WITHOUT INJECTION ON UNION OF OPEN TIBIAL SHAFT FRACTURES WITH EXTERNAL FIXATOR

Background : Open tibial fractures are notorious fractures because the open wound leaves us with limited options and means multiple operations with long intervals for the patient. The usual method of treatment of contaminated, late presenting and complicated fractures is a temporary external fixator followed by conversion into a costly definitive procedure once the wound has healed. The secondary definitive procedure also means extra cost in an already economically stressed patient.In our set up we have to often let patients leave with a plaster cast after removing the external fixator for economic constrains. Per cetaceous autologous bone marrow injection while the patient is on external fixator is one alternative that we have tried to deal with this problem hoping for a primary union without any costly intervention. Materials and methods : We had 42 cases of open tibial fractures which were treated with external fixator and per cutaneous bone marrow injection while 38 other cases which were used as control with only the external fixator and no injections. We included open fractures of only Gustilo Anderson type II,IIIA and B for our study. Study was conducted between period of June 2012 and December 2013 at SBKS medical college . Results : In group one, 34 of the 42 patients had a radiological union before 12 weeks while another 2 in 16 weeks. For group 2 , only 16 of the 38patients had radiological union at 12 weeks and no more at 16 weeks. The average time of union for group 1 was 10 weeks while of group 2 was 12 weeks .Function of the union cases of both the groups was similar in all aspects including distance of walking and ability to carry out daily activities. Conclusion : Per cutaneous autologous bone marrow injections are cheap , easily available and successful alternative to a secondary procedure for open tibial fractures on external fixators.

A COMPARATIVE STUDY OF IN VIVO EFFECT OF PERCUTANEOUS BONE MARROW INJECTION VS WITHOUT INJECTION ON UNION OF OPEN TIBIAL SHAFT FRACTURES WITH EXTERNAL FIXATOR.

Background : Open tibial fractures are notorious fractures because the open wound leaves us with limited options and means multiple operations with long intervals for the patient. The usual method of treatment of contaminated, late presenting and complicated fractures is a temporary external fixator followed by conversion into a costly definitive procedure once the wound has healed. The secondary definitive procedure also means extra cost in an already economically stressed patient.In our set up we have to often let patients leave with a plaster cast after removing the external fixator for economic constrains. Per cetaceous autologous bone marrow injection while the patient is on external fixator is one alternative that we have tried to deal with this problem hoping for a primary union without any costly intervention. Materials and methods : We had 42 cases of open tibial fractures which were treated with external fixator and per cutaneous bone marrow injection while 38 other cases which were used as control with only the external fixator and no injections. We included open fractures of only Gustilo Anderson type II,IIIA and B for our study. Study was conducted between period of June 2012 and December 2013 at SBKS medical college . Results : In group one, 34 of the 42 patients had a radiological union before 12 weeks while another 2 in 16 weeks. For group 2 , only 16 of the 38patients had radiological union at 12 weeks and no more at 16 weeks. The average time of union for group 1 was 10 weeks while of group 2 was 12 weeks .Function of the union cases of both the groups was similar in all aspects including distance of walking and ability to carry out daily activities. Conclusion : Per cutaneous autologous bone marrow injections are cheap , easily available and successful alternative to a secondary procedure for open tibial fractures on external fixators.

Can bone marrow aspirate improve mandibular fracture repair in camels (Camelus dromedarius)? A preliminary study.

BackgroundMandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing.ObjectivesTo investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation.MethodsThirty dromedary camels aged 5–8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline).ResultsCompared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day.ConclusionsBM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.

Minimally Invasive Technique For Delayed union Or Nonunion #Tibia: The Use Of Percutaneous Autologous Bone Marrow Injection

Minimally Invasive Technique For Delayed union Or Nonunion #Tibia: The Use Of Percutaneous Autologous Bone Marrow Injection

Multidirectional percutaneous drilling and autologous bone marrow injection for the treatment of femoral diaphyseal nonunions: a prospective interventional study.

BackgroundTo examine the outcomes of multidirectional percutaneous drilling and autologous concentrated bone marrow (BM) transplantation for atrophic femoral diaphyseal nonunion characterized by intact hardware and mechanical stability at the nonunion site.MethodsFourteen patients (22–63 years of age) were admitted to our hospital with atrophic femoral diaphyseal nonunion. All patients were treated with a combination of multidirectional percutaneous drilling and autologous concentrated BM transplantation. Radiographic evaluation was conducted every month after transplantation until bone healing was achieved.ResultsBony union was achieved in 13 of the 14 patients (92.9%) after an average of 3.9 months (range: 2.5–6 months). The average radiographic union scale in tibial (RUST) scale score improved significantly from the preoperative period (6.15±1.21) to follow-up (11.23±0.73; P<0.05). The mean follow-up after transplantation was 31.4±9.5 months (range: 18–50 months). At the final follow-up, the quality of function had improved significantly, allowing a return to normal activities.ConclusionCombined multidirectional percutaneous drilling and autologous concentrated BM transplantation is an easy, safe, inexpensive, and efficacious method to treat atrophic femoral diaphyseal nonunion characterized by intact hardware and mechanical stability at the nonunion site.Trial registration number: ISRCTN29808592

Less invasive treatment for delayed or nonunion: The use of percutaneous autologous bone marrow injection

Less invasive treatment for delayed or nonunion: The use of percutaneous autologous bone marrow injection

Injeção percutânea de medula óssea autóloga para tratamento de retardo de consolidação ou pseudoartrose de fraturas de ossos longos após fixação interna

ObjectiveThe aim of this study was to assess the results of percutaneous injection of autologous bone marrow in the treatment of fractures presenting with delayed union or non‐union after internal fixation. MethodsThis prospective study was carried out at the Orthopeedics Department from June 2005 to June 2010. A total of 93 patients with delayed union and non‐union (56 delayed unions and 37 non‐unions) of the long bone were recruited from the Emergency and Outpatient Departments and treated with percutaneous autologous bone marrow injections. The clinical results of this study were rated on the basis of the criteria of union. All patients were followed for 24 months. ResultsAll the fractures (delayed union and non‐union) were united within 12 weeks. Most of the patients had discomfort at the donor site for few days; none had problems of persistent pain. The results were excellent in 68.81% (64/93) of cases, good in 19.35% (18/93) of cases, and poor in 11.82% (11/93) of cases. ConclusionPercutaneous autologous bone marrow injection is an effective and safe method for the treatment of diaphyseal non‐union and delayed union. Thus, it is concluded that with an adequate amount of autologous bone marrow injection, successful union in delayed union and non‐union of fractures of long bones can be achieved.