Percutaneous autologous concentrated bone marrow grafting in the treatment for nonunion

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• 作者：Hisashi Sugaya (1)
  Hajime Mishima (1)
  Katsuya Aoto (1)
  Meihua Li (1)
  Yukiyo Shimizu (1)
  Tomokazu Yoshioka (1)
  Shinsuke Sakai (1)
  Hiroshi Akaogi (1)
  Naoyuki Ochiai (1)
  Masashi Yamazaki (1)
  
• 关键词：Nonunion ; Bone marrow ; Concentration ; Percutaneous grafting ; Minimally invasive technique
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：24
• 期：5
• 页码：671-678
• 全文大小：565 KB
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• 作者单位：Hisashi Sugaya (1)
  Hajime Mishima (1)
  Katsuya Aoto (1)
  Meihua Li (1)
  Yukiyo Shimizu (1)
  Tomokazu Yoshioka (1)
  Shinsuke Sakai (1)
  Hiroshi Akaogi (1)
  Naoyuki Ochiai (1)
  Masashi Yamazaki (1)
  
  1. Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
  
• ISSN：1432-1068

文摘

The purpose of this study was to evaluate the clinical and radiographic treatment effects of percutaneous autologous concentrated bone marrow grafting in nonunion cases and to evaluate the effectiveness of this grafting procedure. We enrolled 17 cases those had atrophic changes due to continuous nonunion for over 9?months after injury and had undergone low-intensity pulsed ultrasound treatment for more than 3?months. The site of nonunion was the femur in 10 cases, the tibia in 5 cases, the humerus in 1 case, and the ulna in 1 case. They underwent percutaneous autologous concentrated bone marrow grafting and continued low-intensity pulsed ultrasound stimulation treatment after grafting. Patients were evaluated using the visual analogue scale for pain at immediately before the procedure, 3, 6, and 12?months after grafting. Plain radiographs of the affected site were taken and evaluated about the healing of the nonunion site at each clinical evaluation. As quantitative assessment, CT scans were undertaken before the procedure and 6?months after grafting. The visual analogue scale pain score was reduced consistently after grafting in all patients. About the healing at the nonunion site, 11 and 13 cases of bone union were observed at 6 and 12?months after grafting. The mean volume of callus formation based on CT images was 4,147 (262-7,392) mm3 total between grafting and 6?months. Percutaneous autologous concentrated bone marrow grafting is an effective procedure for the treatment of patients with nonunion.