Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;5(7):287-93.
doi: 10.1302/2046-3758.57.2000587.

Mesenchymal stem cell implantation in atrophic nonunion of the long bones: A translational study

H D Ismail  1 , P Phedy  2 , E Kholinne  2 , Y P Djaja  3 , Y Kusnadi  4 , M Merlina  4 , N D Yulisa  5
Affiliations

Mesenchymal stem cell implantation in atrophic nonunion of the long bones: A translational study

H D Ismail et al. Bone Joint Res. 2016 Jul.

Abstract

Objectives: To explore the therapeutic potential of combining bone marrow-derived mesenchymal stem cells (BM-MSCs) and hydroxyapatite (HA) granules to treat nonunion of the long bone.

Methods: Ten patients with an atrophic nonunion of a long bone fracture were selectively divided into two groups. Five subjects in the treatment group were treated with the combination of 15 million autologous BM-MSCs, 5g/cm(3) (HA) granules and internal fixation. Control subjects were treated with iliac crest autograft, 5g/cm(3) HA granules and internal fixation. The outcomes measured were post-operative pain (visual analogue scale), level of functionality (LEFS and DASH), and radiograph assessment.

Results: Post-operative pain evaluation showed no significant differences between the two groups. The treatment group demonstrated faster initial radiographic and functional improvements. Statistically significant differences in functional scores were present during the first (p = 0.002), second (p = 0.005) and third (p = 0.01) month. Both groups achieved similar outcomes by the end of one-year follow-up. No immunologic or neoplastic side effects were reported.

Conclusions: All cases of nonunion of a long bone presented in this study were successfully treated using autologous BM-MSCs. The combination of autologous BM-MSCs and HA granules is a safe method for treating nonunion. Patients treated with BM-MSCs had faster initial radiographic and functional improvements. By the end of 12 months, both groups had similar outcomes.Cite this article: H.D. Ismail, P. Phedy, E. Kholinne, Y. P. Djaja, Y. Kusnadi, M. Merlina, N. D. Yulisa. Mesenchymal stem cell implantation in atrophic nonunion of the long bones: A translational study. Bone Joint Res 2016;5:287-293. DOI: 10.1302/2046-3758.57.2000587.

Keywords: Atrophic nonunion of the long bones; Bone marrow-derived mesenchymal stem cells (BM-MSCs); Hydroxyapatite (HA) granules.

PubMed Disclaimer

Conflict of interest statement

ICMJE conflict of interest: None declared.

Figures

Fig. 1
Fig. 1
Evaluation of post-operative pain using the visual analogue scale. Data are shown as mean and sd, n = 5 subjects/group, p > 0.05
Fig. 2
Fig. 2
Evaluation of functional scores. Data are shown as mean and sd, n = 5 subjects/group, *p < 0.05
Fig. 3
Fig. 3
Evaluation of Lane-Sandhu Radiologic Score. Data are shown as mean and sd, n = 5 subjects/group, p > 0.05.
Fig. 4
Fig. 4
Evaluation of Tiedema Radiologic Score. Data are shown as mean and sd, n = 5 subjects/group, p > 0.05.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Al-Hadithy N, Sewell MD, Bhavikatti M, Gikas PD. The effect of smoking on fracture healing and on various orthopaedic procedures. Acta Orthop Belg 2012;78:285-290. - PubMed
    1. Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 1984;24:742-746. - PubMed
    1. Guntur AR, Rosen CJ. IGF-1 regulation of key signaling pathways in bone. Bonekey Rep 2013;2:437. - PMC - PubMed
    1. Reverte MM, Dimitriou R, Kanakaris NK, Giannoudis PV. What is the effect of compartment syndrome and fasciotomies on fracture healing in tibial fractures? Injury 2011;42:1402-1407. - PubMed
    1. Dahabreh Z, Dimitriou R, Giannoudis PV. Health economics: a cost analysis of treatment of persistent fracture non-unions using bone morphogenetic protein-7. Injury 2007;38:371-377. - PubMed