Injection Of Autologous Marrow Research Articles

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.

Percutaneous autologous bone marrow injection as a substitute for operative grafting in delayed union and nonunion of long bone fractures

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 of the work 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. Patients and methods Autologous marrow injection was used to stimulate healing in 21 patients with delayed union and nonunion of fracture of the long bones. Of these 21 cases, two patients had fracture shaft femur, one had fracture shaft humerus, and 18 patients had tibial shaft fractures during the period from January 2008 to April 2010 at Tanta University Hospital. Surgical technique Bone marrow aspirated from the posterior iliac crest was injected at the fracture site two to three times with an interval of 3 weeks. Results Marrow stimulated callus formation sufficient to unite 18 of 21 cases of 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.

Osteonecrosis in children and adolescents with cancer – An adverse effect of systemic therapy

Osteonecrosis (ON) is recognised increasingly as a complication of the treatment of cancer in children and adolescents. It is especially prevalent among survivors of acute lymphoblastic leukaemia and non-Hodgkin lymphoma, in whom as many as 1/3 may be affected, likely reflecting the cumulative exposure to glucocorticosteroid therapy. The pathogenesis is complex and includes suppression of bone formation, expansion of the intra-medullary lipocyte compartment and a direct effect on nutrient arteries. Children ⩾10 years of age are at particular risk and the disorder is substantially more common in Whites than in Blacks. Genetic predispositions have been identified. ON is often multi-articular and bilateral, affecting weight-bearing joints predominantly. Surgical management options are of concern in young growing subjects, although injection of autologous marrow into affected sites offers promising results. Other novel approaches include the use of anti-resorptive drugs and strategies for prevention, such as with lipid-lowering agents, are being explored.

Autologous Marrow Injection as a Substitute for Operative Grafting of Tibial Nonunions

Autologous marrow injection was used to stimulate healing in 20 ununited tibial fractures over a five-year period. The technique was employed in conjunction with cast immobilization in ten cases and intramedullary nail fixation in ten cases. Marrow stimulated a callus formation sufficient to unite eight of the ten nonunions immobilized with casts and all ten of the fractures immobilized by intramedullary nails. Bone-marrow injection was as effective as past open autologous grafting but with considerably fewer disadvantages. The technique provides a promptly renewable and reliable source of osteogenic stem cells with numerous advantages compared with standard open-grafting techniques.

Autologous Marrow Injection for Delayed Unions of the Tibia

Over a 3-year period, we have treated 10 delayed unions of the tibia by using percutaneous marrow injection rather than standard operative bone grafting. Nine of the 10 fractures responded by forming callus in the area where the marrow was injected. This relatively simple technique avoided potential problems associated with operative grafting methods that have been standard for at least 50 years. Most importantly, it encourages early treatment of fractures when healing problems are anticipated or are becoming evident.

Comparison of autologous marrow injection to shielding in lethal irradiation of the mouse.

Shielding of small portions of the hematopoietic system provides protection against the lethal effects of whole-body irradiation in the midlethal dose range. Transfusion of either whole blood or transplantation of hematopoietic tissues protects to some degree in every mammalian species studied.Manipulation of the radiation dose, time of transplant and recipient treatment with immune suppressors leads to some success in transplants between species. The probability of acceptance of an allograft is inversely related to the number of histocompatibility differences. Hence, in identical twins with no antigenic differences there should be 100% takes. Several investigators (1-4) have followed Atkinson (5) in attempting transplants between a normal individual and his whole-body irradiated leukemic identical twin. A logical extension of identical twin donor-recipient matching is the autologous transplant. The patient serves as donor and recipient with an interim treatment of radio or chemotherapy. This method has b...