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International Orthopaedics
Published in: International Orthopaedics 4/2011

01-04-2011 | Original Paper

Autologous bone grafting on steroids: preliminary clinical results. A novel treatment for nonunions and segmental bone defects

Authors: Micah A. Miller, Alan Ivkovic, Ryan Porter, Mitchel B. Harris, Daniel M. Estok II, R. Malcolm Smith, Christopher H. Evans, Mark S. Vrahas

Published in: International Orthopaedics | Issue 4/2011

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Abstract

Clinical management of delayed healing or nonunion of long bone fractures and segmental bone defects poses a substantial orthopaedic challenge. Surgical advances and bone tissue engineering are providing new avenues to stimulate bone growth in cases of bone loss and nonunion. The reamer-irrigator-aspirator (RIA) device allows surgeons to aspirate the medullary contents of long bones and use the progenitor-rich “flow-through” fraction in autologous bone grafting. Dexamethasone (DEX) is a synthetic steroid that has been shown to induce osteoblastic differentiation. A series of 13 patients treated with RIA bone grafting enhanced with DEX for nonunion or segmental defect was examined retrospectively to assess the quality of bony union and clinical outcomes. Despite the initial poor prognoses, promising results were achieved using this technique; and given the complexity of these cases the observed success is of great value and warrants controlled study into both standardisation of the procedure and concentration of the grafting material.
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Metadata
Title
Autologous bone grafting on steroids: preliminary clinical results. A novel treatment for nonunions and segmental bone defects
Authors
Micah A. Miller
Alan Ivkovic
Ryan Porter
Mitchel B. Harris
Daniel M. Estok II
R. Malcolm Smith
Christopher H. Evans
Mark S. Vrahas
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 4/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1013-9

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