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International Orthopaedics
Published in: International Orthopaedics 11/2013

01-11-2013 | Original Paper

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

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

Published in: International Orthopaedics | Issue 11/2013

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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.
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Metadata
Title
Repair of segmental long-bone defects by stem cell concentrate augmented scaffolds: a clinical and positron emission tomography - computed tomography analysis
Authors
Maximilian Petri
Ali Namazian
Florian Wilke
Max Ettinger
Timo Stübig
Stephan Brand
Frank Bengel
Christian Krettek
Georg Berding
Michael Jagodzinski
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 11/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2087-y

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