Applying autologous bone marrow stem cell in treatment of long bone nonunions, aseptic femoral head osteonecrosis and limb lengthening

Abstract

are to: 1) evaluate the effect of autologous BMSC on treatment of long bone nonunions, aseptic femoral head osteonecrosis and limb lengthening; 2) determine the relationship between the number of grafted stem cells and the clinical outcome. This study has been conducted on 142 patients with long bone nonunions, 50 patients with aseptic femoral head osteonecrosis, and 36 patients with limbs lengthened by Ilizarov’s principle. Methods: 20-30 milliliters of autologous BMSC mass separated from 250-350 milliliters of aspirated bone marrow fluid have been injected into the sites of bone lesions. The results have shown that: 84.5% patients with bone nonunions have achieved bone union with the bone healing time of 19.8±9.5 weeks; 82% patients with aseptic femoral head osteonecrosis have had good outcome (based on Harris criteria); the bone healing time for 1 centimeter of length in patients with lengthened limbs and grafted BMSC has been 29.5±4.5 days, significantly shorter than that in patients without grafting BMSC. The patients followed up approximately 5 years after being grafted by BMSC have had good outcomes. In conclusion, autologous bone marrow stem cell grafting is a safe and effective method in treatment of long bone nonunion, aseptic femoral head osteonecrosis and limb lengthening; there is a relationship between the number of grafted stem cells and the clinical outcome.