Repair of segmental long-bone defects by stem cell concentrate augmented scaffolds: A clinical and positron emission tomography - Computed tomography analysis

Maximilian Petri, Ali Namazian, Florian Wilke, Max Ettinger, Timo Stübig, Stephan Brand, Frank Bengel, Christian Krettek, Georg Berding, Michael Jagodzinski

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Treating segmental long-bone defects remains a major challenge. For defects >3 cm, segmental transport represents the gold standard, even though the method is time consuming and afflicted with several complications. The aim of this study was to evaluate healing of such defects after grafting an osteogenic scaffold previously seeded with stem cell concentrate. Methods: We evaluated five patients with segmental long-bone defects (3-14 cm) treated with bone marrow aspirate concentrates (BMAC) seeded onto a bovine xenogenous scaffold. The healing process was monitored by X-rays and positron emission tomography-computed tomography (PET-CT) three months after surgery. Results: Centrifugation led to a concentration of leukocytes by factor 8.1 ± 7.5. Full weight bearing was achieved 11.3 ± 5.0 weeks after surgery. PET analysis showed an increased influx of fluoride by factor 8.3 ± 6.4 compared with the contralateral side (p < 0.01). Bone density in the cortical area was 75 ± 16 % of the contralateral side (p < 0.03). The patient with the largest defect sustained an implant failure in the distal femur and finally accomplished therapy by segmental transport. He also had the lowest uptake of fluoride of the patient collective (2.2-fold increase). Conclusion: Stem cell concentrates can be an alternative to segmental bone transport. Further studies are needed to compare this method with autologous bone grafting and segmental transport.

Original languageEnglish (US)
Pages (from-to)2231-2237
Number of pages7
JournalInternational Orthopaedics
Volume37
Issue number11
DOIs
StatePublished - Nov 2013

Keywords

  • Mesenchymal stem cells (MSC)
  • Scaffold
  • Segmental bone defect
  • Stem cell concentrate

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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